How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $7,079Professionalmedian $2,138 · 10th to 90th $1,622 to $2,291
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 $2,089.30 Median $2,137.96 Typical High $6,918.31 | Facility | None | $2,089.30 | $2,137.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,089.30 | $2,137.96 | $2,137.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,168.69 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $354.81 Median $2,187.76 Typical High $2,187.76 | Professional | None | $354.81 | $2,187.76 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,230.27 | $1,949.84 | $3,019.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $4,897.79 | Facility | None | $2,570.40 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,621.81 | $2,137.96 | $2,344.23 |
Priority Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,778.28 | $2,630.27 |
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 $1,778.28 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,778.28 | $2,041.74 | $2,344.23 |
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 $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,047.13 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,548.82 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $309.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,047.13 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $416.87 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,584.89 | $1,621.81 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $208.93 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,513.56 | $1,513.56 |
Where Michigan sits
The same service costs 20.4 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
$2,138
AK $6,607TX $324
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.