How much rates vary
Facilitymedian $1,950 · 10th to 90th $550 to $4,074Professionalmedian $1,413 · 10th to 90th $977 to $2,188
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 $1,380.38 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,380.38 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,380.38 | $1,412.54 | $1,412.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,513.56 | $1,621.81 | $2,290.87 |
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 $812.83 Median $1,122.02 Typical High $1,778.28 | Professional | None | $812.83 | $1,122.02 | $1,778.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $2,818.38 Typical High $4,897.79 | Facility | None | $977.24 | $2,818.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,380.38 | $1,513.56 |
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 $812.83 Median $1,071.52 Typical High $1,479.11 | Professional | None | $812.83 | $1,071.52 | $1,479.11 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $4,168.69 | Facility | None | $426.58 | $602.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $1,445.44 | Professional | None | $676.08 | $1,174.90 | $1,445.44 |
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 $676.08 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $676.08 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,000.00 |
Where Michigan sits
The same service costs 7.8 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
$1,413
AK $4,365TX $562
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.