How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,047 to $7,244Professionalmedian $912 · 10th to 90th $200 to $1,479
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 $891.25 Median $4,897.79 Typical High $6,918.31 | Facility | None | $891.25 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | None | $812.83 | $933.25 | $933.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $169.82 Median $1,047.13 Typical High $1,479.11 | Professional | None | $169.82 | $1,047.13 | $1,479.11 |
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 $562.34 Median $977.24 Typical High $2,511.89 | Professional | None | $562.34 | $977.24 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $5,754.40 | Facility | None | $1,905.46 | $2,691.53 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,148.15 | Professional | None | $776.25 | $912.01 | $1,148.15 |
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 $562.34 Median $812.83 Typical High $2,290.87 | Professional | None | $562.34 | $812.83 | $2,290.87 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,000.00 | Facility | None | $891.25 | $2,818.38 | $10,000.00 |
United Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,202.26 | Professional | None | $851.14 | $977.24 | $1,202.26 |
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 $407.38 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $407.38 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $436.52 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $173.78 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $630.96 |
Where Michigan sits
The same service costs 6.5 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· 37th of 51
$933
AK $3,467UT $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.