How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,047 to $7,586Professionalmedian $1,000 · 10th to 90th $224 to $1,148
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 $1,000.00 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,000.00 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,000.00 | $1,023.29 | $1,023.29 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $4,073.80 Typical High $7,079.46 | Facility | None | $3,981.07 | $4,073.80 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $223.87 Median $707.95 Typical High $1,122.02 | Professional | None | $223.87 | $707.95 | $1,122.02 |
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 $645.65 Median $891.25 Typical High $1,584.89 | Professional | None | $645.65 | $891.25 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $5,754.40 | Facility | None | $1,995.26 | $2,454.71 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,122.02 | Professional | None | $794.33 | $1,000.00 | $1,122.02 |
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 $630.96 Median $851.14 Typical High $1,445.44 | Professional | None | $630.96 | $851.14 | $1,445.44 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,000.00 | Facility | None | $891.25 | $2,818.38 | $10,000.00 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,230.27 | Professional | None | $870.96 | $1,096.48 | $1,230.27 |
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 $501.19 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $501.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $100.00 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Michigan sits
The same service costs 25.1 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· 26th of 51
$1,000
AK $3,090TX $123
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.