How much rates vary
Facilitymedian $2,951 · 10th to 90th $933 to $5,012Professionalmedian $1,000 · 10th to 90th $214 to $1,175
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 $1,000.00 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,000.00 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | None | $870.96 | $1,023.29 | $1,023.29 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $5,128.61 | Facility | None | $2,951.21 | $2,951.21 | $5,128.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $213.80 Median $676.08 Typical High $1,071.52 | Professional | None | $213.80 | $676.08 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $2,454.71 | Professional | None | $562.34 | $891.25 | $2,454.71 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $2,238.72 Typical High $4,897.79 | Facility | None | $977.24 | $2,238.72 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,174.90 | Professional | None | $758.58 | $977.24 | $1,174.90 |
Priority Health Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $1,096.48 | Professional | None | $562.34 | $870.96 | $1,096.48 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $4,570.88 | Facility | None | $602.56 | $1,230.27 | $4,570.88 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
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 $436.52 Median $501.19 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
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· 33rd of 51
$1,000
AK $3,090TX $525
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.