How much rates vary
Facilitymedian $2,239 · 10th to 90th $501 to $4,169Professionalmedian $871 · 10th to 90th $603 to $1,023
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 $870.96 Median $870.96 Typical High $6,918.31 | Facility | None | $870.96 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | None | $870.96 | $891.25 | $891.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,890.45 | Facility | None | $2,238.72 | $2,238.72 | $3,890.45 |
BCBS Michigan Setting Professional Modifier None Typical Low $173.78 Median $1,023.29 Typical High $1,023.29 | Professional | None | $173.78 | $1,023.29 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,445.44 | Professional | None | $562.34 | $776.25 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $870.96 Median $1,819.70 Typical High $4,897.79 | Facility | None | $870.96 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $870.96 | Professional | None | $616.60 | $812.83 | $870.96 |
Priority Health Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,148.15 | Professional | None | $549.54 | $741.31 | $1,148.15 |
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 $724.44 Median $891.25 Typical High $933.25 | Professional | None | $724.44 | $891.25 | $933.25 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Where Michigan sits
The same service costs 5.4 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· 22nd of 51
$871
AK $2,512TX $468
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.