How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,202 to $6,918Professionalmedian $1,380 · 10th to 90th $1,023 to $1,698
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 $1,548.82 Median $1,659.59 Typical High $6,918.31 | Facility | None | $1,548.82 | $1,659.59 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,621.81 | $1,659.59 |
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 $354.81 Median $1,047.13 Typical High $1,698.24 | Professional | None | $354.81 | $1,047.13 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $3,801.89 | Professional | None | $912.01 | $1,348.96 | $3,801.89 |
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 $1,023.29 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,348.96 | $1,584.89 |
Priority Health Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,778.28 | Professional | None | $912.01 | $1,348.96 | $1,778.28 |
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 $1,071.52 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,288.25 | $1,819.70 |
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 $724.44 Median $794.33 Typical High $831.76 | Professional | 52 · Reduced service | $724.44 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $323.59 Typical High $331.13 | Professional | 53 · Discontinued | $288.40 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,202.26 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,202.26 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $239.88 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $162.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $144.54 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,122.02 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,122.02 | $1,148.15 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $776.25 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,122.02 | $1,122.02 |
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
$1,479
AK $4,898TX $759
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.