How much rates vary
Facilitymedian $1,445 · 10th to 90th $427 to $2,884Professionalmedian $234 · 10th to 90th $174 to $309
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 $218.78 Median $281.84 Typical High $4,897.79 | Facility | None | $218.78 | $281.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $281.84 | Professional | None | $204.17 | $229.09 | $281.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,511.89 | Facility | None | $1,445.44 | $1,445.44 | $2,511.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $39.81 Median $234.42 Typical High $288.40 | Professional | None | $39.81 | $234.42 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $380.19 | Professional | None | $154.88 | $234.42 | $380.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $275.42 Median $891.25 Typical High $2,884.03 | Facility | None | $275.42 | $891.25 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $309.03 | Professional | None | $213.80 | $257.04 | $309.03 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $338.84 | Professional | None | $154.88 | $229.09 | $338.84 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,311.31 | Facility | None | $426.58 | $602.56 | $3,311.31 |
United Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $316.23 | Professional | None | $199.53 | $251.19 | $316.23 |
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 $109.65 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 54 · Surgery only | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $41.69 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $194.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $138.04 | Professional | 52 · Reduced service | $107.15 | $107.15 | $138.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $43.65 | $56.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $162.18 | $162.18 | $208.93 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $41.69 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $27.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $194.98 |
Where Michigan sits
The same service costs 4.6 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· 36th of 51
$251
AK $912UT $200
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.