How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $5,248Professionalmedian $1,175 · 10th to 90th $251 to $1,862
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 $1,174.90 Median $1,202.26 Typical High $4,897.79 | Facility | None | $1,174.90 | $1,202.26 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,202.26 | $1,202.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $5,888.44 | Facility | None | $3,388.44 | $3,388.44 | $5,888.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $213.80 Median $1,318.26 Typical High $1,862.09 | Professional | None | $213.80 | $1,318.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,202.26 Typical High $2,884.03 | Professional | None | $660.69 | $1,202.26 | $2,884.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,148.15 Median $2,630.27 Typical High $4,897.79 | Facility | None | $1,148.15 | $2,630.27 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,380.38 | Professional | None | $891.25 | $1,148.15 | $1,380.38 |
Priority Health Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,819.70 | Professional | None | $660.69 | $1,023.29 | $1,819.70 |
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 $1,023.29 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,202.26 | $1,513.56 |
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 $512.86 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $154.88 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $831.76 | $831.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Where Michigan sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 29th of 51
$1,175
AK $3,631UT $631
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.