How much rates vary
Facilitymedian $4,467 · 10th to 90th $501 to $7,079Professionalmedian $1,479 · 10th to 90th $537 to $2,692
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 $1,621.81 Median $1,659.59 Typical High $6,918.31 | Facility | None | $1,621.81 | $1,659.59 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,698.24 | $1,698.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,466.84 Median $4,570.88 Typical High $7,943.28 | Facility | None | $4,466.84 | $4,570.88 | $7,943.28 |
BCBS Michigan Setting Professional Modifier None Typical Low $331.13 Median $1,659.59 Typical High $2,691.53 | Professional | None | $331.13 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $4,466.84 | Professional | None | $912.01 | $1,288.25 | $4,466.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,548.82 Median $2,951.21 Typical High $4,897.79 | Facility | None | $1,548.82 | $2,951.21 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,445.44 | $1,621.81 |
Priority Health Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,137.96 | Professional | None | $977.24 | $1,348.96 | $2,137.96 |
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 $1,047.13 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,230.27 | $1,819.70 |
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 $630.96 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $630.96 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $251.19 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $933.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $186.21 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $316.23 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,148.15 |
Where Michigan sits
The same service costs 5.6 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· 21st of 51
$1,549
AK $5,012UT $891
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.