How much rates vary
Facilitymedian $3,890 · 10th to 90th $490 to $6,166Professionalmedian $1,413 · 10th to 90th $309 to $1,660
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 $1,380.38 Median $1,380.38 Typical High $6,918.31 | Facility | None | $1,380.38 | $1,380.38 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,380.38 | $1,412.54 | $1,412.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $6,760.83 | Facility | None | $3,890.45 | $3,981.07 | $6,760.83 |
BCBS Michigan Setting Professional Modifier None Typical Low $309.03 Median $1,548.82 Typical High $1,659.59 | Professional | None | $309.03 | $1,548.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,187.76 | Professional | None | $912.01 | $1,230.27 | $2,187.76 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,380.38 Median $3,162.28 Typical High $4,897.79 | Facility | None | $1,380.38 | $3,162.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,380.38 | $1,548.82 |
Priority Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,995.26 | Professional | None | $870.96 | $1,174.90 | $1,995.26 |
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 $1,202.26 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,513.56 | $1,659.59 |
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 $691.83 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $691.83 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $954.99 |
Where Michigan sits
The same service costs 24.5 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· 24th of 51
$1,413
AK $4,266TX $174
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.