How much rates vary
Facilitymedian $1,950 · 10th to 90th $490 to $3,981Professionalmedian $407 · 10th to 90th $263 to $513
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 $295.12 Median $457.09 Typical High $4,897.79 | Facility | None | $295.12 | $457.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $457.09 | Professional | None | $295.12 | $346.74 | $457.09 |
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 $58.88 Median $346.74 Typical High $512.86 | Professional | None | $58.88 | $346.74 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $616.60 | Professional | None | $194.98 | $346.74 | $616.60 |
Health Alliance Plan Setting Facility Modifier None Typical Low $309.03 Median $1,096.48 Typical High $2,951.21 | Facility | None | $309.03 | $1,096.48 | $2,951.21 |
Health Alliance Plan Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $512.86 | Professional | None | $309.03 | $457.09 | $512.86 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $549.54 | Professional | None | $181.97 | $316.23 | $549.54 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $467.74 | Professional | None | $269.15 | $371.54 | $467.74 |
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 $147.91 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $147.91 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $67.61 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $338.84 | Professional | 54 · Surgery only | $223.87 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $67.61 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $29.51 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $316.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $162.18 Typical High $234.42 | Professional | 52 · Reduced service | $147.91 | $162.18 | $234.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $66.07 Typical High $93.33 | Professional | 53 · Discontinued | $58.88 | $66.07 | $93.33 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $245.47 Typical High $354.81 | Professional | 54 · Surgery only | $218.78 | $245.47 | $354.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $70.79 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $70.79 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $46.77 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $46.77 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $229.09 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $204.17 | $229.09 | $331.13 |
Where Michigan sits
The same service costs 5.5 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· 21st of 51
$427
AK $1,202TX $219
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.