How much rates vary
Facilitymedian $1,514 · 10th to 90th $537 to $3,090Professionalmedian $525 · 10th to 90th $324 to $692
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 $467.74 Median $645.65 Typical High $4,897.79 | Facility | None | $467.74 | $645.65 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $676.08 | Professional | None | $467.74 | $512.86 | $676.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,630.27 | Facility | None | $1,513.56 | $1,513.56 | $2,630.27 |
BCBS Michigan Setting Professional Modifier None Typical Low $102.33 Median $512.86 Typical High $549.54 | Professional | None | $102.33 | $512.86 | $549.54 |
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 $489.78 Typical High $776.25 | Professional | None | $316.23 | $489.78 | $776.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $660.69 Median $1,288.25 Typical High $4,897.79 | Facility | None | $660.69 | $1,288.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $676.08 | Professional | None | $467.74 | $602.56 | $676.08 |
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 $316.23 Median $489.78 Typical High $724.44 | Professional | None | $316.23 | $489.78 | $724.44 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $4,265.80 | Facility | None | $426.58 | $602.56 | $4,265.80 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $741.31 | Professional | None | $416.87 | $562.34 | $741.31 |
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 $234.42 Median $257.04 Typical High $323.59 | Professional | 52 · Reduced service | $234.42 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $128.82 | Professional | 53 · Discontinued | $93.33 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $489.78 | Professional | 54 · Surgery only | $346.74 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $77.62 Typical High $97.72 | Professional | 55 · Aftercare only | $69.18 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $64.57 | Professional | 56 · Pre-op care only | $46.77 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $457.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $257.04 Typical High $331.13 | Professional | 52 · Reduced service | $234.42 | $257.04 | $331.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $131.83 | Professional | 53 · Discontinued | $93.33 | $102.33 | $131.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $489.78 | Professional | 54 · Surgery only | $346.74 | $380.19 | $489.78 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $100.00 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $100.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $66.07 | Professional | 56 · Pre-op care only | $46.77 | $51.29 | $66.07 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $457.09 |
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· 36th of 51
$550
AK $1,950TX $447
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.