How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $8,128Professionalmedian $1,950 · 10th to 90th $1,288 to $3,090
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 $1,949.84 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,949.84 | $1,995.26 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,995.26 | $2,041.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,248.07 Median $5,370.32 Typical High $9,120.11 | Facility | None | $5,248.07 | $5,370.32 | $9,120.11 |
BCBS Michigan Setting Professional Modifier None Typical Low $407.38 Median $2,041.74 Typical High $3,090.30 | Professional | None | $407.38 | $2,041.74 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,862.09 | $2,238.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,862.09 Median $4,677.35 Typical High $4,897.79 | Facility | None | $1,862.09 | $4,677.35 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,862.09 | $2,290.87 |
Priority Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,380.38 | $2,238.72 |
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 $1,698.24 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,698.24 | $2,187.76 | $2,454.71 |
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 $776.25 Median $1,000.00 Typical High $1,023.29 | Professional | 52 · Reduced service | $776.25 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $398.11 Typical High $407.38 | Professional | 53 · Discontinued | $309.03 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,479.11 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,174.90 | $1,479.11 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $295.12 Typical High $309.03 | Professional | 55 · Aftercare only | $234.42 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $199.53 Typical High $204.17 | Professional | 56 · Pre-op care only | $154.88 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,380.38 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,380.38 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $933.25 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $371.54 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,380.38 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $275.42 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $186.21 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,348.96 | $1,348.96 |
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· 26th of 51
$1,995
AK $5,495TX $1,023
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.