How much rates vary
Facilitymedian $2,630 · 10th to 90th $912 to $4,898Professionalmedian $1,122 · 10th to 90th $871 to $1,820
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,096.48 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,148.15 | $1,148.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $4,570.88 | Facility | None | $2,630.27 | $2,630.27 | $4,570.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $1,819.70 | Professional | None | $758.58 | $1,737.80 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,513.56 | Professional | None | $660.69 | $1,023.29 | $1,513.56 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $4,897.79 | Facility | None | $1,819.70 | $2,290.87 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,230.27 | Professional | None | $870.96 | $1,096.48 | $1,230.27 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,380.38 | Professional | None | $660.69 | $1,000.00 | $1,380.38 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,148.15 | Professional | None | $891.25 | $1,023.29 | $1,148.15 |
13 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $794.33 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 50 · Both sides | $1,949.84 | $1,949.84 | $1,949.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $794.33 |
Where Michigan sits
The same service costs 7.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 25th of 51
$1,148
AK $3,467TX $437
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.