How much rates vary
Facilitymedian $14,125 · 10th to 90th $1,549 to $21,878Professionalmedian $2,512 · 10th to 90th $603 to $3,311
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 $2,570.40 Median $4,897.79 Typical High $6,918.31 | Facility | None | $2,570.40 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,818.38 | $2,818.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $14,125.38 Median $14,454.40 Typical High $25,118.86 | Facility | None | $14,125.38 | $14,454.40 | $25,118.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $436.52 Median $2,454.71 Typical High $3,548.13 | Professional | None | $436.52 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $4,073.80 | Professional | None | $1,621.81 | $2,344.23 | $4,073.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,897.79 Median $6,309.57 Typical High $10,232.93 | Facility | None | $4,897.79 | $6,309.57 | $10,232.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,691.53 | $3,019.95 |
Priority Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $2,951.21 | Professional | None | $1,621.81 | $2,290.87 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $12,302.69 | Facility | None | $1,047.13 | $4,466.84 | $12,302.69 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,344.23 | $2,691.53 |
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 $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,288.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,949.84 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $389.05 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,949.84 | $1,949.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,288.25 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,905.46 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $389.05 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,862.09 | $1,862.09 |
Where Michigan sits
The same service costs 16.2 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· 25th of 51
$2,570
AK $8,128TX $501
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.