How much rates vary
Facilitymedian $3,311 · 10th to 90th $891 to $6,457Professionalmedian $724 · 10th to 90th $479 to $851
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 $707.95 Median $4,897.79 Typical High $6,918.31 | Facility | None | $707.95 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | None | $630.96 | $758.58 | $758.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,311.31 Median $3,388.44 Typical High $5,888.44 | Facility | None | $3,311.31 | $3,388.44 | $5,888.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $162.18 Median $501.19 Typical High $812.83 | Professional | None | $162.18 | $501.19 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,995.26 | Professional | None | $446.68 | $758.58 | $1,995.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,479.11 Median $2,570.40 Typical High $5,754.40 | Facility | None | $1,479.11 | $2,570.40 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $912.01 | Professional | None | $588.84 | $724.44 | $912.01 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,778.28 | Professional | None | $446.68 | $630.96 | $1,778.28 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $933.25 | Professional | None | $645.65 | $741.31 | $933.25 |
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 $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $141.25 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $524.81 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $512.86 |
Where Michigan sits
The same service costs 6.9 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
$741
AK $2,754UT $398
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.