How much rates vary
Facilitymedian $1,479 · 10th to 90th $490 to $3,162Professionalmedian $380 · 10th to 90th $263 to $525
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 $354.81 Median $416.87 Typical High $4,897.79 | Facility | None | $354.81 | $416.87 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $407.38 | Professional | None | $251.19 | $302.00 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $2,570.40 | Facility | None | $1,479.11 | $1,513.56 | $2,570.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $616.60 | Professional | None | $257.04 | $436.52 | $616.60 |
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 $229.09 Median $363.08 Typical High $562.34 | Professional | None | $229.09 | $363.08 | $562.34 |
Health Alliance Plan Setting Facility Modifier None Typical Low $371.54 Median $1,258.93 Typical High $4,897.79 | Facility | None | $371.54 | $1,258.93 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $436.52 | Professional | None | $269.15 | $363.08 | $436.52 |
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 $218.78 Median $338.84 Typical High $501.19 | Professional | None | $218.78 | $338.84 | $501.19 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $4,570.88 | Facility | None | $602.56 | $1,230.27 | $4,570.88 |
United Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $416.87 | Professional | None | $309.03 | $371.54 | $416.87 |
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 $177.83 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $177.83 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $70.79 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $302.00 | Professional | 54 · Surgery only | $269.15 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $54.95 Typical High $60.26 | Professional | 55 · Aftercare only | $53.70 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $35.48 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $257.04 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $251.19 | $257.04 | $281.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $181.97 Typical High $204.17 | Professional | 52 · Reduced service | $177.83 | $181.97 | $204.17 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $81.28 | Professional | 53 · Discontinued | $70.79 | $72.44 | $81.28 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $275.42 | $309.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $61.66 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $40.74 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $40.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $257.04 | $288.40 |
Where Michigan sits
The same service costs 6.8 times more in Alaska than in Utah. 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· 32nd of 51
$380
AK $1,288UT $191
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.