How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,122 to $6,026Professionalmedian $1,230 · 10th to 90th $229 to $1,380
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 $1,230.27 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,230.27 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,623.41 | Facility | None | $3,235.94 | $3,311.31 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $229.09 Median $1,288.25 Typical High $1,348.96 | Professional | None | $229.09 | $1,288.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,905.46 | Professional | None | $794.33 | $1,096.48 | $1,905.46 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $5,754.40 | Facility | None | $2,238.72 | $2,570.40 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,258.93 | Professional | None | $891.25 | $1,174.90 | $1,258.93 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,513.56 | Professional | None | $724.44 | $1,023.29 | $1,513.56 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,762.47 | Facility | None | $851.14 | $2,238.72 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,288.25 | $1,445.44 |
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 $616.60 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $933.25 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
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· 22nd of 51
$1,230
AK $3,802TX $617
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.