How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,000 to $6,918Professionalmedian $1,778 · 10th to 90th $1,230 to $2,089
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 $1,778.28 Median $1,905.46 Typical High $6,918.31 | Facility | None | $1,778.28 | $1,905.46 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,862.09 | $1,905.46 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $6,918.31 | Facility | None | $3,981.07 | $3,981.07 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $389.05 Median $1,230.27 Typical High $1,949.84 | Professional | None | $389.05 | $1,230.27 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $4,466.84 | Professional | None | $1,047.13 | $1,862.09 | $4,466.84 |
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 $1,548.82 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,862.09 | $2,238.72 |
Priority Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,698.24 | $2,884.03 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,737.80 | $2,344.23 |
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 $851.14 Median $933.25 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,380.38 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,288.25 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,288.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,288.25 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $891.25 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $363.08 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,348.96 | $1,412.54 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $269.15 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $177.83 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,318.26 | $1,318.26 |
Where Michigan sits
The same service costs 6.5 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· 32nd of 51
$1,862
AK $5,754TX $891
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.