How much rates vary
Facilitymedian $3,467 · 10th to 90th $794 to $6,026Professionalmedian $550 · 10th to 90th $389 to $631
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 $575.44 Median $2,884.03 Typical High $4,897.79 | Facility | None | $575.44 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $616.60 | Professional | None | $457.09 | $588.84 | $616.60 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $6,025.60 | Facility | None | $3,467.37 | $3,467.37 | $6,025.60 |
BCBS Michigan Setting Professional Modifier None Typical Low $107.15 Median $389.05 Typical High $630.96 | Professional | None | $107.15 | $389.05 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $691.83 | Professional | None | $316.23 | $478.63 | $691.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $4,897.79 | Facility | None | $1,047.13 | $1,288.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $645.65 | Professional | None | $416.87 | $537.03 | $645.65 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $2,951.21 | Professional | None | $302.00 | $478.63 | $2,951.21 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $691.83 | Professional | None | $436.52 | $549.54 | $691.83 |
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 $229.09 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $229.09 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $91.20 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $346.74 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $69.18 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $323.59 | $416.87 | $426.58 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $275.42 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $112.20 | $112.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $407.38 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $56.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $380.19 | $398.11 | $398.11 |
Where Michigan sits
The same service costs 5.4 times more in Alaska than in New York. 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· 38th of 51
$575
AK $2,239NY $417
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.