How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,288 to $10,000Professionalmedian $1,549 · 10th to 90th $1,023 to $2,455
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 $1,479.11 Median $1,548.82 Typical High $6,918.31 | Facility | None | $1,479.11 | $1,548.82 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,479.11 | $1,548.82 | $1,548.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $10,232.93 | Facility | None | $5,888.44 | $5,888.44 | $10,232.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $316.23 Median $1,659.59 Typical High $2,454.71 | Professional | None | $316.23 | $1,659.59 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,041.74 | Professional | None | $891.25 | $1,380.38 | $2,041.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,019.95 Median $4,897.79 Typical High $5,011.87 | Facility | None | $3,019.95 | $4,897.79 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,513.56 | $1,737.80 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $1,862.09 | Professional | None | $891.25 | $1,380.38 | $1,862.09 |
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 $1,230.27 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,479.11 | $1,621.81 |
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 $741.31 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $741.31 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,096.48 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,630.27 Typical High $2,630.27 | Professional | 50 · Both sides | $2,238.72 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $741.31 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,096.48 |
Where Michigan sits
The same service costs 8.3 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· 30th of 51
$1,549
AK $4,786TX $575
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.