How much rates vary
Facilitymedian $1,479 · 10th to 90th $661 to $3,467Professionalmedian $537 · 10th to 90th $437 to $851
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 $524.81 Median $2,884.03 Typical High $4,897.79 | Facility | None | $524.81 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | None | $457.09 | $524.81 | $524.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,570.40 | Facility | None | $1,479.11 | $1,479.11 | $2,570.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $95.50 Median $562.34 Typical High $851.14 | Professional | None | $95.50 | $562.34 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $1,445.44 | Professional | None | $295.12 | $537.03 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $4,897.79 | Facility | None | $1,122.02 | $1,174.90 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $645.65 | Professional | None | $446.68 | $501.19 | $645.65 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $1,258.93 | Professional | None | $295.12 | $478.63 | $1,258.93 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $676.08 | Professional | None | $457.09 | $549.54 | $676.08 |
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 $229.09 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Where Michigan sits
The same service costs 6.2 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· 35th of 51
$562
AK $1,862UT $302
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.