How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,122 to $6,918Professionalmedian $1,175 · 10th to 90th $794 to $1,288
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 $1,174.90 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,174.90 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,202.26 | $1,202.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $346.74 Median $1,202.26 Typical High $1,288.25 | Professional | None | $346.74 | $1,202.26 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $2,570.40 | Professional | None | $691.83 | $1,047.13 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $4,897.79 | Facility | None | $2,238.72 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,288.25 | Professional | None | $912.01 | $1,174.90 | $1,288.25 |
Priority Health Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,548.82 | Professional | None | $691.83 | $1,047.13 | $1,548.82 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,202.26 | Professional | None | $954.99 | $1,096.48 | $1,202.26 |
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 $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $588.84 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
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· 25th of 51
$1,175
AK $3,715TX $186
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.