How much rates vary
Facilitymedian $1,738 · 10th to 90th $676 to $3,715Professionalmedian $316 · 10th to 90th $66 to $363
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 $316.23 Median $870.96 Typical High $6,918.31 | Facility | None | $316.23 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | None | $275.42 | $316.23 | $316.23 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,737.80 | $1,778.28 | $3,090.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $58.88 Median $346.74 Typical High $346.74 | Professional | None | $58.88 | $346.74 | $346.74 |
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 $204.17 Median $295.12 Typical High $501.19 | Professional | None | $204.17 | $295.12 | $501.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $616.60 Median $1,412.54 Typical High $4,897.79 | Facility | None | $616.60 | $1,412.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $354.81 | Professional | None | $251.19 | $316.23 | $354.81 |
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 $186.21 Median $275.42 Typical High $457.09 | Professional | None | $186.21 | $275.42 | $457.09 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $371.54 | Professional | None | $275.42 | $346.74 | $371.54 |
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 $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $234.42 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $218.78 |
Where Michigan sits
The same service costs 6.0 times more in Alaska than in Utah. 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
$316
AK $1,000UT $166
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.