How much rates vary
Facilitymedian $4,467 · 10th to 90th $501 to $6,918Professionalmedian $1,660 · 10th to 90th $1,096 to $1,950
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 $1,659.59 Median $1,698.24 Typical High $6,918.31 | Facility | None | $1,659.59 | $1,698.24 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,698.24 | $1,737.80 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,466.84 Median $4,570.88 Typical High $7,762.47 | Facility | None | $4,466.84 | $4,570.88 | $7,762.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $302.00 Median $1,778.28 Typical High $1,778.28 | Professional | None | $302.00 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,621.81 Typical High $1,949.84 | Professional | None | $912.01 | $1,621.81 | $1,949.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,584.89 Median $3,801.89 Typical High $4,897.79 | Facility | None | $1,584.89 | $3,801.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,584.89 | $1,949.84 |
Priority Health Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $2,511.89 | Professional | None | $870.96 | $1,621.81 | $2,511.89 |
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 $1,479.11 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,819.70 | $2,089.30 |
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 $660.69 Median $831.76 Typical High $870.96 | Professional | 52 · Reduced service | $660.69 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $338.84 Typical High $346.74 | Professional | 53 · Discontinued | $263.03 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,258.93 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,000.00 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $199.53 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $131.83 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $933.25 | $1,174.90 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $794.33 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $316.23 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $158.49 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,148.15 |
Where Michigan sits
The same service costs 5.5 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· 28th of 51
$1,698
AK $4,677TX $851
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.