How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,023 to $6,918Professionalmedian $1,047 · 10th to 90th $224 to $1,259
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 $1,047.13 Median $1,047.13 Typical High $6,918.31 | Facility | None | $1,047.13 | $1,047.13 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,047.13 | Professional | None | $1,023.29 | $1,023.29 | $1,047.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $691.83 Typical High $1,122.02 | Professional | None | $190.55 | $691.83 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,698.24 | Professional | None | $676.08 | $977.24 | $1,698.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $4,897.79 | Facility | None | $2,290.87 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,288.25 | Professional | None | $912.01 | $1,047.13 | $1,288.25 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,548.82 | Professional | None | $630.96 | $933.25 | $1,548.82 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,318.26 | Professional | None | $933.25 | $1,202.26 | $1,318.26 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Where Michigan sits
The same service costs 6.5 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· 27th of 51
$1,047
AK $3,311TX $513
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.