How much rates vary
Facilitymedian $10,000 · 10th to 90th $1,349 to $15,488Professionalmedian $3,388 · 10th to 90th $2,291 to $5,495
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 $3,388.44 Median $3,467.37 Typical High $6,918.31 | Facility | None | $3,388.44 | $3,467.37 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,388.44 | $3,467.37 | $3,467.37 |
BCBS Michigan Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $17,378.01 | Facility | None | $10,000.00 | $10,000.00 | $17,378.01 |
BCBS Michigan Setting Professional Modifier None Typical Low $724.44 Median $5,128.61 Typical High $5,495.41 | Professional | None | $724.44 | $5,128.61 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $4,265.80 | Professional | None | $2,041.74 | $3,162.28 | $4,265.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,897.79 Median $5,011.87 Typical High $8,128.31 | Facility | None | $4,897.79 | $5,011.87 | $8,128.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $3,890.45 | Professional | None | $2,754.23 | $3,467.37 | $3,890.45 |
Priority Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,041.74 | $3,162.28 | $4,168.69 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,235.94 Typical High $3,630.78 | Professional | None | $2,818.38 | $3,235.94 | $3,630.78 |
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 $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,698.24 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $676.08 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,511.89 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,454.71 | $2,454.71 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,698.24 | $1,737.80 | $1,737.80 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,511.89 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $501.19 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $338.84 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,454.71 | $2,454.71 |
Where Michigan sits
The same service costs 8.7 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· 25th of 51
$3,467
AK $10,715TX $1,230
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.