How much rates vary
Facilitymedian $5,370 · 10th to 90th $501 to $8,318Professionalmedian $1,862 · 10th to 90th $407 to $2,089
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 $1,862.09 Median $1,862.09 Typical High $6,918.31 | Facility | None | $1,862.09 | $1,862.09 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $9,332.54 | Facility | None | $5,370.32 | $5,370.32 | $9,332.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $407.38 Median $2,041.74 Typical High $2,041.74 | Professional | None | $407.38 | $2,041.74 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,621.81 | $2,884.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $4,265.80 Typical High $4,897.79 | Facility | None | $1,819.70 | $4,265.80 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,819.70 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,584.89 | $2,691.53 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,995.26 | $2,238.72 |
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 $912.01 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $912.01 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,380.38 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $912.01 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $363.08 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
Where Michigan sits
The same service costs 5.2 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
$1,862
AK $4,898TX $933
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.