How much rates vary
Facilitymedian $2,455 · 10th to 90th $955 to $4,898Professionalmedian $1,660 · 10th to 90th $1,259 to $3,020
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 $1,737.80 Median $1,819.70 Typical High $6,918.31 | Facility | None | $1,737.80 | $1,819.70 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,737.80 | $1,819.70 | $1,819.70 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,265.80 | Facility | None | $2,454.71 | $2,454.71 | $4,265.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $346.74 Median $2,041.74 Typical High $3,019.95 | Professional | None | $346.74 | $2,041.74 | $3,019.95 |
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 $1,047.13 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,445.44 | $2,454.71 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,621.81 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,621.81 | $1,819.70 |
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 $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,412.54 | $2,238.72 |
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 $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,548.82 | $1,698.24 |
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 $870.96 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $870.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $346.74 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,318.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $173.78 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,258.93 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $870.96 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,318.26 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,288.25 | $1,288.25 |
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· 29th of 51
$1,660
AK $5,623TX $708
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.