How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,202 to $6,918Professionalmedian $2,455 · 10th to 90th $1,862 to $3,090
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 $2,818.38 Median $2,951.21 Typical High $6,918.31 | Facility | None | $2,818.38 | $2,951.21 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,818.38 | $2,951.21 | $2,951.21 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $6,918.31 | Facility | None | $3,981.07 | $3,981.07 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,630.27 | $3,090.30 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $3,715.35 | Professional | None | $1,698.24 | $2,570.40 | $3,715.35 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $5,495.41 | Facility | None | $2,570.40 | $2,951.21 | $5,495.41 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,862.09 | $2,398.83 | $2,951.21 |
Priority Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,698.24 | $2,290.87 | $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 $2,089.30 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,089.30 | $2,398.83 | $2,818.38 |
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 $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,412.54 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $562.34 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,137.96 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $281.84 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,041.74 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,412.54 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $575.44 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,137.96 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $426.58 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $288.40 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,089.30 | $2,089.30 |
Where Michigan sits
The same service costs 21.4 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· 32nd of 51
$2,512
AK $9,120TX $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.