How much rates vary
Facilitymedian $4,898 · 10th to 90th $501 to $7,586Professionalmedian $1,738 · 10th to 90th $1,380 to $2,089
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 $1,737.80 Median $1,778.28 Typical High $6,918.31 | Facility | None | $1,737.80 | $1,778.28 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,778.28 | $1,819.70 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $8,511.38 | Facility | None | $4,897.79 | $4,897.79 | $8,511.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,819.70 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,041.74 | Professional | None | $954.99 | $1,584.89 | $2,041.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $4,897.79 | Facility | None | $1,659.59 | $4,073.80 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,659.59 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,041.74 | Professional | None | $912.01 | $1,230.27 | $2,041.74 |
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 $1,513.56 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,862.09 | $2,187.76 |
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 $691.83 Median $891.25 Typical High $912.01 | Professional | 52 · Reduced service | $691.83 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $354.81 Typical High $371.54 | Professional | 53 · Discontinued | $275.42 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $177.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $1,230.27 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $831.76 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,202.26 |
Where Michigan sits
The same service costs 5.4 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
$1,778
AK $5,012TX $933
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.