How much rates vary
Facilitymedian $3,236 · 10th to 90th $912 to $6,026Professionalmedian $1,148 · 10th to 90th $776 to $1,318
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 $1,148.15 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,148.15 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,000.00 | $1,148.15 | $1,148.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,623.41 | Facility | None | $3,235.94 | $3,311.31 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,230.27 | Professional | None | $758.58 | $1,148.15 | $1,230.27 |
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 $645.65 Median $1,148.15 Typical High $2,754.23 | Professional | None | $645.65 | $1,148.15 | $2,754.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $4,897.79 | Facility | None | $1,819.70 | $2,344.23 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,348.96 | Professional | None | $891.25 | $1,096.48 | $1,348.96 |
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 $645.65 Median $1,023.29 Typical High $2,238.72 | Professional | None | $645.65 | $1,023.29 | $2,238.72 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,244.36 | Facility | None | $660.69 | $1,548.82 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,174.90 | $1,479.11 |
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 $501.19 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Michigan sits
The same service costs 5.6 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· 34th of 51
$1,148
AK $3,548UT $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.