How much rates vary
Facilitymedian $4,266 · 10th to 90th $501 to $6,607Professionalmedian $1,514 · 10th to 90th $1,072 to $2,570
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 $1,148.15 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,584.89 | $1,584.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,265.80 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,698.24 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $3,388.44 | Professional | None | $891.25 | $1,513.56 | $3,388.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $4,897.79 | Facility | None | $1,445.44 | $3,548.13 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,479.11 | $1,862.09 |
Priority Health Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,862.09 | Professional | None | $891.25 | $1,513.56 | $1,862.09 |
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 $1,230.27 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,412.54 | $1,905.46 |
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 $676.08 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $676.08 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $269.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,174.90 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $234.42 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,096.48 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,096.48 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,047.13 |
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· 24th of 51
$1,514
AK $4,571TX $676
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.