How much rates vary
Facilitymedian $1,698 · 10th to 90th $661 to $3,631Professionalmedian $589 · 10th to 90th $129 to $646
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 $602.56 Median $2,884.03 Typical High $4,897.79 | Facility | None | $602.56 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | None | $501.19 | $616.60 | $616.60 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $2,951.21 | Facility | None | $1,698.24 | $1,737.80 | $2,951.21 |
BCBS Michigan Setting Professional Modifier None Typical Low $109.65 Median $616.60 Typical High $645.65 | Professional | None | $109.65 | $616.60 | $645.65 |
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 $371.54 Median $512.86 Typical High $1,445.44 | Professional | None | $371.54 | $512.86 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $4,897.79 | Facility | None | $1,122.02 | $1,174.90 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $676.08 | Professional | None | $446.68 | $575.44 | $676.08 |
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 $371.54 Median $512.86 Typical High $1,513.56 | Professional | None | $371.54 | $512.86 | $1,513.56 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,025.60 | Facility | None | $602.56 | $1,230.27 | $6,025.60 |
United Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $741.31 | Professional | None | $501.19 | $575.44 | $741.31 |
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 $245.47 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $245.47 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $50.12 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $346.74 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $288.40 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $117.49 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $436.52 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $87.10 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $60.26 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $407.38 | $426.58 | $426.58 |
Where Michigan sits
The same service costs 6.5 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· 33rd of 51
$603
AK $1,995TX $309
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.