How much rates vary
Facilitymedian $1,862 · 10th to 90th $933 to $4,074Professionalmedian $1,023 · 10th to 90th $708 to $3,311
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 $1,023.29 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,023.29 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,023.29 | $1,096.48 | $1,096.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,862.09 | $1,905.46 | $3,311.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $416.87 Median $2,344.23 Typical High $3,311.31 | Professional | None | $416.87 | $2,344.23 | $3,311.31 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,174.90 | Professional | None | $562.34 | $776.25 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $5,754.40 | Facility | None | $1,348.96 | $1,862.09 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,047.13 | Professional | None | $707.95 | $933.25 | $1,047.13 |
Priority Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Priority Health Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,380.38 | Professional | None | $549.54 | $724.44 | $1,380.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,023.29 | Professional | None | $741.31 | $831.76 | $1,023.29 |
13 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 $512.86 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $758.58 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 50 · Both sides | $3,548.13 | $3,548.13 | $3,548.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $724.44 |
Where Michigan sits
The same service costs 4.6 times more in Alaska than in New York. 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
$1,047
AK $3,090NY $676
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.