How much rates vary
Facilitymedian $1,514 · 10th to 90th $537 to $3,090Professionalmedian $562 · 10th to 90th $339 to $661
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 $562.34 Median $2,041.74 Typical High $4,897.79 | Facility | None | $562.34 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $131.83 Median $630.96 Typical High $660.69 | Professional | None | $131.83 | $630.96 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $954.99 | Professional | None | $354.81 | $489.78 | $954.99 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $1,096.48 Typical High $4,897.79 | Facility | None | $954.99 | $1,096.48 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $588.84 | Professional | None | $416.87 | $562.34 | $588.84 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $851.14 | Professional | None | $338.84 | $478.63 | $851.14 |
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 $478.63 Median $562.34 Typical High $645.65 | Professional | None | $478.63 | $562.34 | $645.65 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Where Michigan sits
The same service costs 6.2 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· 23rd of 51
$562
AK $1,862TX $302
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.