How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,288 to $9,120Professionalmedian $1,778 · 10th to 90th $1,175 to $2,042
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 $1,778.28 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,778.28 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,778.28 | $1,862.09 | $1,862.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,248.07 Median $5,370.32 Typical High $9,120.11 | Facility | None | $5,248.07 | $5,370.32 | $9,120.11 |
BCBS Michigan Setting Professional Modifier None Typical Low $389.05 Median $1,862.09 Typical High $2,089.30 | Professional | None | $389.05 | $1,862.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,659.59 | $2,454.71 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,630.78 Median $5,011.87 Typical High $5,754.40 | Facility | None | $3,630.78 | $5,011.87 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,819.70 | $2,041.74 |
Priority Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,659.59 | $2,238.72 |
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 $1,445.44 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,698.24 | $1,862.09 |
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 $891.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $891.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $354.81 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,348.96 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $177.83 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $891.25 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $354.81 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,348.96 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $269.15 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $177.83 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,288.25 | $1,288.25 |
Where Michigan sits
The same service costs 18.6 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
$1,778
AK $5,623TX $302
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.