How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,202 to $8,128Professionalmedian $724 · 10th to 90th $550 to $1,202
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 $691.83 Median $4,073.80 Typical High $5,754.40 | Facility | None | $691.83 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | None | $691.83 | $724.44 | $724.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $8,128.31 | Facility | None | $2,630.27 | $3,388.44 | $8,128.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,258.93 | Professional | None | $812.83 | $870.96 | $1,258.93 |
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 $416.87 Median $616.60 Typical High $1,445.44 | Professional | None | $416.87 | $616.60 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $4,897.79 | Facility | None | $1,348.96 | $1,778.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $776.25 | Professional | None | $549.54 | $691.83 | $776.25 |
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 $416.87 Median $616.60 Typical High $977.24 | Professional | None | $416.87 | $616.60 | $977.24 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,120.11 | Facility | None | $891.25 | $2,818.38 | $9,120.11 |
United Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $691.83 | Professional | None | $562.34 | $616.60 | $691.83 |
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 $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $501.19 |
Where Michigan sits
The same service costs 7.9 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· 26th of 51
$724
AK $2,239TX $282
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.