How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $8,128Professionalmedian $1,259 · 10th to 90th $977 to $2,042
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 $1,202.26 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,202.26 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,258.93 | $1,318.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,265.80 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,348.96 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,659.59 | Professional | None | $724.44 | $1,122.02 | $1,659.59 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,454.71 Median $5,011.87 Typical High $5,754.40 | Facility | None | $2,454.71 | $5,011.87 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,380.38 | Professional | None | $977.24 | $1,258.93 | $1,380.38 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,513.56 | Professional | None | $724.44 | $1,122.02 | $1,513.56 |
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 $1,000.00 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,148.15 | $1,288.25 |
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 $602.56 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $602.56 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $602.56 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $891.25 |
Where Michigan sits
The same service costs 7.9 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· 30th of 51
$1,259
AK $3,890TX $490
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.