How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,000 to $7,244Professionalmedian $1,000 · 10th to 90th $741 to $1,622
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 $977.24 Median $4,897.79 Typical High $6,918.31 | Facility | None | $977.24 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | None | $977.24 | $1,000.00 | $1,000.00 |
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 $218.78 Median $1,096.48 Typical High $1,621.81 | Professional | None | $218.78 | $1,096.48 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,318.26 | Professional | None | $575.44 | $851.14 | $1,318.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $5,754.40 | Facility | None | $1,905.46 | $2,570.40 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,096.48 | Professional | None | $776.25 | $977.24 | $1,096.48 |
Priority Health Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,288.25 | Professional | None | $575.44 | $812.83 | $1,288.25 |
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 $812.83 Median $891.25 Typical High $1,000.00 | Professional | None | $812.83 | $891.25 | $1,000.00 |
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 $489.78 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $707.95 |
Where Michigan sits
The same service costs 16.6 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· 29th of 51
$1,000
AK $3,090TX $186
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.