How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,349 to $9,772Professionalmedian $2,089 · 10th to 90th $1,585 to $2,570
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 $4,897.79 Typical High $6,918.31 | Facility | None | $2,290.87 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,290.87 | $2,511.89 | $2,511.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,623.41 Median $5,754.40 Typical High $9,772.37 | Facility | None | $5,623.41 | $5,754.40 | $9,772.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,995.26 | $2,290.87 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,630.78 | Professional | None | $1,445.44 | $1,862.09 | $3,630.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,981.07 Median $4,168.69 Typical High $5,754.40 | Facility | None | $3,981.07 | $4,168.69 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,584.89 | $2,089.30 | $2,398.83 |
Priority Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,862.09 | $2,691.53 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,698.24 | $1,819.70 | $2,187.76 |
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 $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,148.15 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,737.80 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,737.80 | $1,737.80 |
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 $457.09 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $457.09 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,737.80 | $1,778.28 | $1,778.28 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $346.74 | $354.81 | $354.81 |
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 $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,659.59 | $1,659.59 |
Where Michigan sits
The same service costs 11.2 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
$2,089
AK $7,244TX $646
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.