How much rates vary
Facilitymedian $10,233 · 10th to 90th $1,445 to $16,596Professionalmedian $3,020 · 10th to 90th $2,291 to $5,623
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 $3,467.37 Median $3,630.78 Typical High $6,918.31 | Facility | None | $3,467.37 | $3,630.78 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,467.37 | $3,630.78 | $3,630.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $10,232.93 Median $10,471.29 Typical High $18,197.01 | Facility | None | $10,232.93 | $10,471.29 | $18,197.01 |
BCBS Michigan Setting Professional Modifier None Typical Low $724.44 Median $5,623.41 Typical High $5,623.41 | Professional | None | $724.44 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,089.30 | $3,235.94 | $4,365.16 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,897.79 Median $6,760.83 Typical High $14,791.08 | Facility | None | $4,897.79 | $6,760.83 | $14,791.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,290.87 | $2,951.21 | $3,630.78 |
Priority Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,089.30 | $3,162.28 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $12,302.69 | Facility | None | $1,047.13 | $4,466.84 | $12,302.69 |
United Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,467.37 | Professional | None | $2,630.27 | $3,019.95 | $3,467.37 |
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 $1,737.80 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,737.80 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $707.95 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,630.27 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $524.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $346.74 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,570.40 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,737.80 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,737.80 | $1,819.70 | $1,819.70 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $707.95 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,630.27 | $2,754.23 | $2,754.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $524.81 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $354.81 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,570.40 | $2,570.40 |
Where Michigan sits
The same service costs 20.0 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· 34th of 51
$3,162
AK $11,220TX $562
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.