How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $5,370Professionalmedian $1,202 · 10th to 90th $776 to $2,512
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 $1,445.44 Median $1,513.56 Typical High $6,918.31 | Facility | None | $1,445.44 | $1,513.56 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,445.44 | $1,548.82 | $1,548.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,388.44 Median $3,467.37 Typical High $5,888.44 | Facility | None | $3,388.44 | $3,467.37 | $5,888.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,621.81 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,290.87 | Professional | None | $891.25 | $1,288.25 | $2,290.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $4,897.79 | Facility | None | $1,412.54 | $2,137.96 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,479.11 | Professional | None | $741.31 | $954.99 | $1,479.11 |
Priority Health Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,659.59 | Professional | None | $891.25 | $1,174.90 | $1,659.59 |
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 $870.96 Median $1,000.00 Typical High $1,348.96 | Professional | None | $870.96 | $1,000.00 | $1,348.96 |
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 $724.44 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $724.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $295.12 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $707.95 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,047.13 |
Where Michigan sits
The same service costs 21.9 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· 27th of 51
$1,288
AK $4,467TX $204
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.