How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,023 to $6,918Professionalmedian $1,230 · 10th to 90th $209 to $2,455
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 $933.25 Median $2,041.74 Typical High $6,918.31 | Facility | None | $933.25 | $2,041.74 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $1,995.26 | Professional | None | $933.25 | $1,513.56 | $1,995.26 |
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 $177.83 Median $645.65 Typical High $1,047.13 | Professional | None | $177.83 | $645.65 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $2,884.03 | Professional | None | $707.95 | $1,230.27 | $2,884.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,041.74 Median $4,786.30 Typical High $6,918.31 | Facility | None | $2,041.74 | $4,786.30 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $977.24 Median $2,089.30 Typical High $2,511.89 | Professional | None | $977.24 | $2,089.30 | $2,511.89 |
Priority Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Priority Health Setting Professional Modifier None Typical Low $575.44 Median $1,202.26 Typical High $2,630.27 | Professional | None | $575.44 | $1,202.26 | $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 $912.01 Median $1,479.11 Typical High $2,290.87 | Professional | None | $912.01 | $1,479.11 | $2,290.87 |
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 $467.74 Median $758.58 Typical High $1,000.00 | Professional | 52 · Reduced service | $467.74 | $758.58 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $302.00 Typical High $398.11 | Professional | 53 · Discontinued | $186.21 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,148.15 Typical High $1,513.56 | Professional | 54 · Surgery only | $707.95 | $1,148.15 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $229.09 Typical High $302.00 | Professional | 55 · Aftercare only | $141.25 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $151.36 Typical High $199.53 | Professional | 56 · Pre-op care only | $93.33 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,071.52 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $660.69 | $1,071.52 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $676.08 Typical High $1,047.13 | Professional | 52 · Reduced service | $467.74 | $676.08 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $275.42 Typical High $426.58 | Professional | 53 · Discontinued | $186.21 | $275.42 | $426.58 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,023.29 Typical High $1,584.89 | Professional | 54 · Surgery only | $691.83 | $1,023.29 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $204.17 Typical High $316.23 | Professional | 55 · Aftercare only | $141.25 | $204.17 | $316.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $134.90 Typical High $208.93 | Professional | 56 · Pre-op care only | $93.33 | $134.90 | $208.93 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $954.99 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $645.65 | $954.99 | $1,479.11 |
Where Michigan sits
The same service costs 4.9 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· 28th of 51
$1,514
AK $4,074TX $832
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.