How much rates vary
Facilitymedian $3,090 · 10th to 90th $501 to $5,012Professionalmedian $1,047 · 10th to 90th $708 to $1,230
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 $1,000.00 Median $1,047.13 Typical High $6,918.31 | Facility | None | $1,000.00 | $1,047.13 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | None | $912.01 | $1,071.52 | $1,071.52 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $5,370.32 | Facility | None | $3,090.30 | $3,090.30 | $5,370.32 |
BCBS Michigan Setting Professional Modifier None Typical Low $229.09 Median $707.95 Typical High $1,148.15 | Professional | None | $229.09 | $707.95 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $2,511.89 | Professional | None | $645.65 | $912.01 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,000.00 | $2,511.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
Priority Health Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,318.26 | Professional | None | $645.65 | $912.01 | $1,318.26 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,348.96 | Professional | None | $933.25 | $1,071.52 | $1,348.96 |
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 $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $457.09 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $91.20 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $501.19 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $741.31 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $724.44 |
Where Michigan sits
The same service costs 6.3 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· 30th of 51
$1,047
AK $3,388UT $537
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.