How much rates vary
Facilitymedian $10,715 · 10th to 90th $1,288 to $16,982Professionalmedian $1,660 · 10th to 90th $1,202 to $2,818
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 $1,659.59 Median $1,698.24 Typical High $6,918.31 | Facility | None | $1,659.59 | $1,698.24 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,659.59 | $1,698.24 | $1,698.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $10,715.19 Median $10,964.78 Typical High $18,620.87 | Facility | None | $10,715.19 | $10,964.78 | $18,620.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $501.19 Median $2,089.30 Typical High $2,818.38 | Professional | None | $501.19 | $2,089.30 | $2,818.38 |
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 $1,000.00 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,000.00 | $1,479.11 | $3,019.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $4,897.79 | Facility | None | $2,818.38 | $2,818.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,659.59 | $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 $1,000.00 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,479.11 | $2,290.87 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $891.25 | $2,818.38 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,513.56 | $1,659.59 |
13 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 $831.76 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $831.76 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,202.26 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 50 · Both sides | $3,019.95 | $3,019.95 | $3,019.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $831.76 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,202.26 |
Where Michigan sits
The same service costs 7.4 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· 28th of 51
$1,660
AK $5,248TX $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.