How much rates vary
Facilitymedian $977 · 10th to 90th $324 to $2,042Professionalmedian $288 · 10th to 90th $174 to $324
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 $199.53 Median $309.03 Typical High $4,897.79 | Facility | None | $199.53 | $309.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $302.00 | Professional | None | $199.53 | $208.93 | $302.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,737.80 | Facility | None | $977.24 | $1,000.00 | $1,737.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | None | $199.53 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $457.09 | Professional | None | $125.89 | $223.87 | $457.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $302.00 Median $724.44 Typical High $4,897.79 | Facility | None | $302.00 | $724.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $331.13 | Professional | None | $208.93 | $302.00 | $331.13 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $338.84 | Professional | None | $117.49 | $218.78 | $338.84 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,089.30 | Facility | None | $288.40 | $426.58 | $2,089.30 |
United Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $323.59 | Professional | None | $165.96 | $234.42 | $323.59 |
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 $100.00 Median $104.71 Typical High $147.91 | Professional | 52 · Reduced service | $100.00 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $41.69 Typical High $60.26 | Professional | 53 · Discontinued | $39.81 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $223.87 | Professional | 54 · Surgery only | $151.36 | $158.49 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $44.67 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.89 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.95 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $147.91 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $141.25 | $147.91 | $208.93 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $104.71 Typical High $154.88 | Professional | 52 · Reduced service | $100.00 | $104.71 | $154.88 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $41.69 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $41.69 | $63.10 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $234.42 | Professional | 54 · Surgery only | $151.36 | $158.49 | $234.42 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $46.77 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $46.77 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.89 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.95 | $20.89 | $31.62 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $147.91 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $141.25 | $147.91 | $218.78 |
Where Michigan sits
The same service costs 4.2 times more in Alaska than in Virginia. 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
$288
AK $776VA $186
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.