How much rates vary
Facilitymedian $5,012 · 10th to 90th $955 to $8,128Professionalmedian $1,950 · 10th to 90th $1,047 to $2,951
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 $1,862.09 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,862.09 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,862.09 | $1,949.84 | $1,949.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $8,709.64 | Facility | None | $5,011.87 | $5,011.87 | $8,709.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $407.38 Median $2,041.74 Typical High $3,090.30 | Professional | None | $407.38 | $2,041.74 | $3,090.30 |
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 $1,122.02 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,737.80 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $4,897.79 | Facility | None | $3,162.28 | $3,981.07 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,905.46 | $2,137.96 |
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 $1,122.02 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,513.56 | $2,344.23 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,621.81 | $1,949.84 |
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 $933.25 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $933.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $380.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,412.54 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $281.84 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,380.38 | $1,380.38 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 50 · Both sides | $3,311.31 | $3,311.31 | $3,311.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $933.25 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $380.19 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,412.54 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $281.84 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $186.21 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,380.38 | $1,380.38 |
Where Michigan sits
The same service costs 8.9 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· 23rd of 51
$1,950
AK $6,026TX $676
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.