How much rates vary
Facilitymedian $3,631 · 10th to 90th $501 to $5,754Professionalmedian $1,230 · 10th to 90th $263 to $1,995
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 $1,230.27 Median $1,258.93 Typical High $6,918.31 | Facility | None | $1,230.27 | $1,258.93 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,258.93 | $1,258.93 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $6,309.57 | Facility | None | $3,630.78 | $3,630.78 | $6,309.57 |
BCBS Michigan Setting Professional Modifier None Typical Low $223.87 Median $831.76 Typical High $1,995.26 | Professional | None | $223.87 | $831.76 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $3,019.95 | Professional | None | $707.95 | $1,258.93 | $3,019.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,202.26 Median $2,818.38 Typical High $4,897.79 | Facility | None | $1,202.26 | $2,818.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,479.11 | Professional | None | $954.99 | $1,202.26 | $1,479.11 |
Priority Health Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,949.84 | Professional | None | $707.95 | $1,096.48 | $1,949.84 |
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 $1,096.48 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,288.25 | $1,621.81 |
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 $549.54 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $812.83 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $758.58 | $870.96 | $891.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $912.01 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
Where Michigan sits
The same service costs 7.9 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· 31st of 51
$1,230
AK $3,802TX $479
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.