How much rates vary
Facilitymedian $18,621 · 10th to 90th $1,230 to $28,840Professionalmedian $1,047 · 10th to 90th $224 to $1,148
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 $1,047.13 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,047.13 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,047.13 | Professional | None | $912.01 | $1,047.13 | $1,047.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $18,620.87 Median $19,054.61 Typical High $33,113.11 | Facility | None | $18,620.87 | $19,054.61 | $33,113.11 |
BCBS Michigan Setting Professional Modifier None Typical Low $186.21 Median $1,047.13 Typical High $1,096.48 | Professional | None | $186.21 | $1,047.13 | $1,096.48 |
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 $588.84 Median $1,047.13 Typical High $2,884.03 | Professional | None | $588.84 | $1,047.13 | $2,884.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,995.26 Median $4,073.80 Typical High $8,511.38 | Facility | None | $1,995.26 | $4,073.80 | $8,511.38 |
Health Alliance Plan Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,230.27 | Professional | None | $794.33 | $1,000.00 | $1,230.27 |
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 $588.84 Median $933.25 Typical High $2,511.89 | Professional | None | $588.84 | $933.25 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $12,302.69 | Facility | None | $1,047.13 | $4,466.84 | $12,302.69 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,318.26 | Professional | None | $891.25 | $1,071.52 | $1,318.26 |
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 $457.09 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $676.08 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $630.96 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Michigan sits
The same service costs 6.8 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· 35th of 51
$1,047
AK $3,715TX $550
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.