How much rates vary
Facilitymedian $2,291 · 10th to 90th $813 to $4,571Professionalmedian $741 · 10th to 90th $603 to $1,000
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 $616.60 Median $812.83 Typical High $6,918.31 | Facility | None | $616.60 | $812.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $831.76 | Professional | None | $616.60 | $645.65 | $831.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,981.07 | Facility | None | $2,290.87 | $2,290.87 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $1,047.13 | Professional | None | $416.87 | $741.31 | $1,047.13 |
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 $407.38 Median $660.69 Typical High $1,148.15 | Professional | None | $407.38 | $660.69 | $1,148.15 |
Health Alliance Plan Setting Facility Modifier None Typical Low $812.83 Median $1,258.93 Typical High $4,897.79 | Facility | None | $812.83 | $1,258.93 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $912.01 | Professional | None | $645.65 | $812.83 | $912.01 |
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 $371.54 Median $630.96 Typical High $933.25 | Professional | None | $371.54 | $630.96 | $933.25 |
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 $562.34 Median $691.83 Typical High $851.14 | Professional | None | $562.34 | $691.83 | $851.14 |
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 $309.03 Median $323.59 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $123.03 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $575.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $323.59 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $323.59 | $426.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $169.82 | Professional | 53 · Discontinued | $123.03 | $128.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $478.63 | $645.65 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $128.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $85.11 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $85.11 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $602.56 |
Where Michigan sits
The same service costs 5.8 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· 29th of 51
$759
AK $2,455TX $427
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.