How much rates vary
Facilitymedian $1,479 · 10th to 90th $513 to $2,884Professionalmedian $513 · 10th to 90th $363 to $603
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 $512.86 Median $2,884.03 Typical High $4,897.79 | Facility | None | $512.86 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | None | $446.68 | $512.86 | $512.86 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $2,630.27 | Facility | None | $1,479.11 | $1,513.56 | $2,630.27 |
BCBS Michigan Setting Professional Modifier None Typical Low $102.33 Median $363.08 Typical High $602.56 | Professional | None | $102.33 | $363.08 | $602.56 |
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 $338.84 Median $426.58 Typical High $1,258.93 | Professional | None | $338.84 | $426.58 | $1,258.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $4,897.79 | Facility | None | $512.86 | $1,288.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $660.69 | Professional | None | $436.52 | $512.86 | $660.69 |
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 $338.84 Median $426.58 Typical High $645.65 | Professional | None | $338.84 | $426.58 | $645.65 |
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 $436.52 Median $512.86 Typical High $660.69 | Professional | None | $436.52 | $512.86 | $660.69 |
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 $218.78 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $218.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $331.13 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $309.03 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $77.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Where Michigan sits
The same service costs 6.0 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· 34th of 51
$513
AK $1,380UT $229
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.