How much rates vary
Facilitymedian $3,715 · 10th to 90th $501 to $5,754Professionalmedian $1,318 · 10th to 90th $1,072 to $2,239
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 $1,288.25 Median $1,380.38 Typical High $6,918.31 | Facility | None | $1,288.25 | $1,380.38 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,380.38 | $1,380.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $6,456.54 | Facility | None | $3,715.35 | $3,715.35 | $6,456.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,479.11 | $2,089.30 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $2,951.21 | Professional | None | $776.25 | $1,318.26 | $2,951.21 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,258.93 Median $3,162.28 Typical High $4,897.79 | Facility | None | $1,258.93 | $3,162.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,288.25 | $1,659.59 |
Priority Health Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,621.81 | Professional | None | $776.25 | $1,318.26 | $1,621.81 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,230.27 | $1,659.59 |
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 $575.44 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $234.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $114.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $977.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $912.01 |
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· 22nd of 51
$1,380
AK $3,981TX $589
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.