How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $3,715Professionalmedian $724 · 10th to 90th $525 to $871
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 $2,884.03 Typical High $4,897.79 | Facility | None | $741.31 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | None | $741.31 | $758.58 | $758.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $3,090.30 | Facility | None | $1,778.28 | $1,819.70 | $3,090.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $151.36 Median $870.96 Typical High $870.96 | Professional | None | $151.36 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,258.93 | Professional | None | $478.63 | $630.96 | $1,258.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $4,897.79 | Facility | None | $1,318.26 | $1,412.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $758.58 | Professional | None | $537.03 | $691.83 | $758.58 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $1,047.13 | Professional | None | $467.74 | $630.96 | $1,047.13 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $812.83 | Professional | None | $602.56 | $724.44 | $812.83 |
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 $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 $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $75.86 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
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 $2,344TX $427
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.