How much rates vary
Facilitymedian $4,074 · 10th to 90th $501 to $6,457Professionalmedian $1,445 · 10th to 90th $1,072 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 $1,445.44 Median $1,445.44 Typical High $6,918.31 | Facility | None | $1,445.44 | $1,445.44 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,258.93 | $1,445.44 | $1,445.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $7,244.36 | Facility | None | $4,073.80 | $4,168.69 | $7,244.36 |
BCBS Michigan Setting Professional Modifier None Typical Low $302.00 Median $1,513.56 Typical High $2,187.76 | Professional | None | $302.00 | $1,513.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,348.96 Typical High $3,467.37 | Professional | None | $812.83 | $1,348.96 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,412.54 Median $3,715.35 Typical High $4,897.79 | Facility | None | $1,412.54 | $3,715.35 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,412.54 | $1,819.70 |
Priority Health Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $1,584.89 | Professional | None | $812.83 | $1,288.25 | $1,584.89 |
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 $1,258.93 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,479.11 | $1,862.09 |
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 $630.96 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $630.96 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $251.19 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $954.99 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $891.25 | $1,023.29 | $1,023.29 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $977.24 |
Where Michigan sits
The same service costs 5.9 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· 28th of 51
$1,479
AK $4,467TX $759
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.