How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,202 to $11,749Professionalmedian $2,344 · 10th to 90th $1,413 to $2,630
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 $2,290.87 Median $2,344.23 Typical High $6,918.31 | Facility | None | $2,290.87 | $2,344.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,290.87 | $2,344.23 | $2,344.23 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $13,182.57 | Facility | None | $7,585.78 | $7,585.78 | $13,182.57 |
BCBS Michigan Setting Professional Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,398.83 | Professional | None | $478.63 | $1,513.56 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,412.54 | $2,089.30 | $3,388.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,754.40 | Facility | None | $4,073.80 | $4,073.80 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,398.83 | $2,754.23 |
Priority Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,348.96 | $2,089.30 | $2,884.03 |
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 $1,995.26 Median $2,344.23 Typical High $2,691.53 | Professional | None | $1,995.26 | $2,344.23 | $2,691.53 |
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 $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,148.15 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,698.24 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,621.81 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,148.15 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $467.74 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,737.80 | $1,819.70 | $1,819.70 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,698.24 | $1,698.24 |
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· 28th of 51
$2,344
AK $7,244TX $363
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.