How much rates vary
Facilitymedian $4,365 · 10th to 90th $513 to $6,918Professionalmedian $1,479 · 10th to 90th $933 to $2,344
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 $1,479.11 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,479.11 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,513.56 | $1,513.56 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $7,585.78 | Facility | None | $4,365.16 | $4,365.16 | $7,585.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $269.15 Median $2,238.72 Typical High $2,344.23 | Professional | None | $269.15 | $2,238.72 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $3,630.78 | Professional | None | $851.14 | $1,318.26 | $3,630.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $3,388.44 Typical High $5,754.40 | Facility | None | $1,445.44 | $3,388.44 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,445.44 | $1,778.28 |
Priority Health Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $1,621.81 | Professional | None | $851.14 | $1,318.26 | $1,621.81 |
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 $1,318.26 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,548.82 | $1,949.84 |
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 $660.69 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,122.02 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,047.13 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $1,047.13 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,023.29 |
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· 30th of 51
$1,514
AK $4,571UT $794
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.