How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,122 to $12,882Professionalmedian $2,818 · 10th to 90th $525 to $3,162
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 $2,951.21 Median $3,019.95 Typical High $6,918.31 | Facility | None | $2,951.21 | $3,019.95 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,951.21 | $3,019.95 | $3,019.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,317.64 Median $8,511.38 Typical High $14,454.40 | Facility | None | $8,317.64 | $8,511.38 | $14,454.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $524.81 Median $1,949.84 Typical High $2,951.21 | Professional | None | $524.81 | $1,949.84 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,754.23 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,754.23 | $3,890.45 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,073.80 | $7,079.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,467.37 | Professional | None | $2,454.71 | $3,090.30 | $3,467.37 |
Priority Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $3,715.35 | Professional | None | $1,737.80 | $2,691.53 | $3,715.35 |
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 $2,454.71 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,454.71 | $2,818.38 | $3,162.28 |
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 $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,479.11 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,187.76 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $436.52 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $295.12 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,137.96 | $2,137.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,479.11 | $1,513.56 | $1,513.56 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $588.84 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,187.76 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $436.52 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $295.12 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,137.96 | $2,137.96 |
Where Michigan sits
The same service costs 21.9 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· 31st of 51
$2,818
AK $9,333TX $427
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.