How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,072 to $6,918Professionalmedian $1,549 · 10th to 90th $1,023 to $2,455
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 $1,479.11 Median $1,584.89 Typical High $6,918.31 | Facility | None | $1,479.11 | $1,584.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,584.89 | Professional | None | $1,412.54 | $1,548.82 | $1,584.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $323.59 Median $1,621.81 Typical High $2,454.71 | Professional | None | $323.59 | $1,621.81 | $2,454.71 |
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 $870.96 Median $1,584.89 Typical High $2,570.40 | Professional | None | $870.96 | $1,584.89 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $4,897.79 | Facility | None | $2,570.40 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,548.82 | $2,187.76 |
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 $870.96 Median $1,584.89 Typical High $2,570.40 | Professional | None | $870.96 | $1,584.89 | $2,570.40 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,621.81 | $2,089.30 |
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 $707.95 Median $776.25 Typical High $794.33 | Professional | 52 · Reduced service | $707.95 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $234.42 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $741.31 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $295.12 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,148.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,071.52 |
Where Michigan sits
The same service costs 6.8 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· 30th of 51
$1,622
AK $4,786TX $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.