How much rates vary
Facilitymedian $2,951 · 10th to 90th $501 to $4,898Professionalmedian $1,096 · 10th to 90th $851 to $1,288
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 $1,096.48 Median $1,122.02 Typical High $6,918.31 | Facility | None | $1,096.48 | $1,122.02 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,148.15 | Professional | None | $870.96 | $1,122.02 | $1,148.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $5,128.61 | Facility | None | $2,951.21 | $2,951.21 | $5,128.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $204.17 Median $1,202.26 Typical High $1,202.26 | Professional | None | $204.17 | $1,202.26 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,288.25 | Professional | None | $602.56 | $1,047.13 | $1,288.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,047.13 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,047.13 | $2,511.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
Priority Health Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,288.25 | Professional | None | $562.34 | $758.58 | $1,288.25 |
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 $954.99 Median $1,202.26 Typical High $1,380.38 | Professional | None | $954.99 | $1,202.26 | $1,380.38 |
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 $436.52 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $177.83 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $776.25 | $812.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $758.58 |
Where Michigan sits
The same service costs 4.6 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· 25th of 51
$1,148
AK $3,162TX $692
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.