How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,349 to $9,333Professionalmedian $1,995 · 10th to 90th $437 to $2,344
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 $1,995.26 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,995.26 | $1,995.26 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,995.26 | $2,041.74 | $2,041.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $9,772.37 | Facility | None | $5,623.41 | $5,623.41 | $9,772.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $371.54 Median $2,089.30 Typical High $2,187.76 | Professional | None | $371.54 | $2,089.30 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,778.28 | $3,090.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,949.84 Median $4,466.84 Typical High $4,897.79 | Facility | None | $1,949.84 | $4,466.84 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,949.84 | $2,187.76 |
Priority Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,737.80 | $2,884.03 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $8,709.64 | Facility | None | $891.25 | $2,818.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,778.28 | $2,238.72 | $2,398.83 |
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 $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $398.11 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,479.11 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $295.12 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,412.54 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $977.24 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,380.38 |
Where Michigan sits
The same service costs 6.3 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· 24th of 51
$1,995
AK $6,166TX $977
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.