How much rates vary
Facilitymedian $4,677 · 10th to 90th $501 to $7,244Professionalmedian $1,738 · 10th to 90th $1,175 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 $1,412.54 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,778.28 | $1,862.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $8,128.31 | Facility | None | $4,677.35 | $4,786.30 | $8,128.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $316.23 Median $1,862.09 Typical High $1,995.26 | Professional | None | $316.23 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,698.24 Typical High $2,041.74 | Professional | None | $977.24 | $1,698.24 | $2,041.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $4,897.79 | Facility | None | $1,659.59 | $3,981.07 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,659.59 | $2,041.74 |
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 $1,905.46 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,905.46 | $2,238.72 |
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 $707.95 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $707.95 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $354.81 Typical High $371.54 | Professional | 53 · Discontinued | $281.84 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,348.96 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,348.96 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $269.15 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $141.25 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,258.93 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $1,258.93 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $831.76 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,258.93 | $1,288.25 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,202.26 | $1,202.26 |
Where Michigan sits
The same service costs 4.8 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· 26th of 51
$1,778
AK $5,012TX $1,047
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.