How much rates vary
Facilitymedian $2,570 · 10th to 90th $871 to $4,898Professionalmedian $912 · 10th to 90th $741 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 $870.96 Median $4,073.80 Typical High $5,754.40 | Facility | None | $870.96 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $912.01 | Professional | None | $707.95 | $912.01 | $912.01 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $4,466.84 | Facility | None | $2,570.40 | $2,630.27 | $4,466.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $575.44 Median $1,479.11 Typical High $1,479.11 | Professional | None | $575.44 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $2,137.96 | Professional | None | $549.54 | $794.33 | $2,137.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $891.25 Median $2,290.87 Typical High $4,897.79 | Facility | None | $891.25 | $2,290.87 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,096.48 | Professional | None | $776.25 | $891.25 | $1,096.48 |
Priority Health Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,122.02 | Professional | None | $549.54 | $794.33 | $1,122.02 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,025.60 | Facility | None | $660.69 | $1,548.82 | $6,025.60 |
United Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,148.15 | Professional | None | $812.83 | $912.01 | $1,148.15 |
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 $354.81 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $354.81 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $616.60 |
Where Michigan sits
The same service costs 6.9 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
$933
AK $2,884TX $417
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.