How much rates vary
Facilitymedian $2,188 · 10th to 90th $661 to $4,467Professionalmedian $646 · 10th to 90th $490 to $1,047
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 $645.65 Median $660.69 Typical High $4,897.79 | Facility | None | $645.65 | $660.69 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | None | $630.96 | $645.65 | $645.65 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $3,801.89 | Facility | None | $2,187.76 | $2,238.72 | $3,801.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $141.25 Median $707.95 Typical High $1,047.13 | Professional | None | $141.25 | $707.95 | $1,047.13 |
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 $371.54 Median $660.69 Typical High $1,584.89 | Professional | None | $371.54 | $660.69 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $2,884.03 | Facility | None | $660.69 | $1,318.26 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $776.25 | Professional | None | $501.19 | $630.96 | $776.25 |
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 $371.54 Median $588.84 Typical High $1,548.82 | Professional | None | $371.54 | $588.84 | $1,548.82 |
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 $575.44 Median $660.69 Typical High $831.76 | Professional | None | $575.44 | $660.69 | $831.76 |
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 $309.03 Median $316.23 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Where Michigan sits
The same service costs 5.5 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
$676
AK $2,042UT $372
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.