How much rates vary
Facilitymedian $4,074 · 10th to 90th $851 to $6,761Professionalmedian $759 · 10th to 90th $562 to $1,445
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 $831.76 Median $851.14 Typical High $6,918.31 | Facility | None | $831.76 | $851.14 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | None | $831.76 | $870.96 | $870.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,073.80 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $1,348.96 Typical High $1,445.44 | Professional | None | $190.55 | $1,348.96 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,202.26 | Professional | None | $501.19 | $724.44 | $1,202.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $4,897.79 | Facility | None | $1,479.11 | $2,041.74 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $851.14 | Professional | None | $588.84 | $758.58 | $851.14 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $891.25 | Professional | None | $501.19 | $630.96 | $891.25 |
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 $630.96 Median $691.83 Typical High $794.33 | Professional | None | $630.96 | $691.83 | $794.33 |
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 $416.87 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $630.96 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $165.96 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $602.56 |
Where Michigan sits
The same service costs 5.8 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· 31st of 51
$776
AK $2,570UT $447
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.