How much rates vary
Facilitymedian $661 · 10th to 90th $372 to $2,089Professionalmedian $1,096 · 10th to 90th $692 to $1,479
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 $891.25 Median $1,122.02 Typical High $1,174.90 | Professional | None | $891.25 | $1,122.02 | $1,174.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $1,148.15 | Facility | None | $660.69 | $660.69 | $1,148.15 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $691.83 Typical High $1,096.48 | Professional | None | $190.55 | $691.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,258.93 | Professional | None | $616.60 | $1,202.26 | $1,258.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $588.84 Median $1,071.52 Typical High $4,897.79 | Facility | None | $588.84 | $1,071.52 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,412.54 | Professional | None | $977.24 | $1,071.52 | $1,412.54 |
Priority Health Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,258.93 | Professional | None | $575.44 | $870.96 | $1,258.93 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,570.40 | Facility | None | $288.40 | $426.58 | $2,570.40 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,288.25 | $1,584.89 |
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 $446.68 Median $562.34 Typical High $588.84 | Professional | 52 · Reduced service | $446.68 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $223.87 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $676.08 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $112.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $630.96 | $776.25 | $812.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $524.81 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $218.78 | $218.78 |
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 $158.49 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $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 4.4 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· 31st of 51
$1,072
AK $3,020TX $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.