How much rates vary
Facilitymedian $1,000 · 10th to 90th $550 to $2,042Professionalmedian $724 · 10th to 90th $537 to $851
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 $741.31 Median $741.31 Typical High $6,918.31 | Facility | None | $741.31 | $741.31 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,737.80 | Facility | None | $1,000.00 | $1,000.00 | $1,737.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $851.14 | Professional | None | $537.03 | $851.14 | $851.14 |
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 $478.63 Median $676.08 Typical High $1,202.26 | Professional | None | $478.63 | $676.08 | $1,202.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $549.54 Median $724.44 Typical High $4,897.79 | Facility | None | $549.54 | $724.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $776.25 | Professional | None | $549.54 | $724.44 | $776.25 |
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 $457.09 Median $660.69 Typical High $1,023.29 | Professional | None | $457.09 | $660.69 | $1,023.29 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $831.76 | Professional | None | $630.96 | $741.31 | $831.76 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where Michigan sits
The same service costs 5.5 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· 25th of 51
$724
AK $2,188TX $398
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.