How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,175 to $8,710Professionalmedian $1,175 · 10th to 90th $891 to $1,950
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 $1,174.90 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,174.90 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,174.90 | $1,230.27 | $1,230.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,897.79 Median $5,011.87 Typical High $8,709.64 | Facility | None | $4,897.79 | $5,011.87 | $8,709.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $776.25 Median $1,412.54 Typical High $1,949.84 | Professional | None | $776.25 | $1,412.54 | $1,949.84 |
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 $707.95 Median $1,096.48 Typical High $2,818.38 | Professional | None | $707.95 | $1,096.48 | $2,818.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,238.72 Median $4,897.79 Typical High $5,011.87 | Facility | None | $2,238.72 | $4,897.79 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,258.93 | Professional | None | $891.25 | $1,174.90 | $1,258.93 |
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 $707.95 Median $1,071.52 Typical High $1,621.81 | Professional | None | $707.95 | $1,071.52 | $1,621.81 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,258.93 | Professional | None | $954.99 | $1,122.02 | $1,258.93 |
12 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 $588.84 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $588.84 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $588.84 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Where Michigan sits
The same service costs 14.5 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· 33rd of 51
$1,175
AK $3,715TX $257
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.