How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,202 to $6,918Professionalmedian $1,622 · 10th to 90th $1,122 to $1,820
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 $1,621.81 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,621.81 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,548.82 | $1,698.24 | $1,737.80 |
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 $363.08 Median $1,819.70 Typical High $1,819.70 | Professional | None | $363.08 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $4,073.80 | Professional | None | $954.99 | $1,659.59 | $4,073.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $5,754.40 | Facility | None | $2,570.40 | $3,235.94 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,621.81 | $1,905.46 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,570.40 | Professional | None | $954.99 | $1,445.44 | $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 $1,230.27 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,479.11 | $2,041.74 |
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 $776.25 Median $851.14 Typical High $870.96 | Professional | 52 · Reduced service | $776.25 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $346.74 | Professional | 53 · Discontinued | $309.03 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,174.90 |
Where Michigan sits
The same service costs 6.6 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· 33rd of 51
$1,660
AK $5,248TX $794
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.