How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $9,333Professionalmedian $1,318 · 10th to 90th $912 to $1,549
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 $1,318.26 Median $1,380.38 Typical High $6,918.31 | Facility | None | $1,318.26 | $1,380.38 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,380.38 | $1,380.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $9,549.93 | Facility | None | $5,495.41 | $5,495.41 | $9,549.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $295.12 Median $1,380.38 Typical High $2,187.76 | Professional | None | $295.12 | $1,380.38 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,819.70 | Professional | None | $794.33 | $1,230.27 | $1,819.70 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,630.27 Median $4,897.79 Typical High $5,011.87 | Facility | None | $2,630.27 | $4,897.79 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,318.26 | $1,479.11 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,659.59 | Professional | None | $794.33 | $1,202.26 | $1,659.59 |
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 $1,096.48 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,230.27 | $1,380.38 |
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 $660.69 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $660.69 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $954.99 |
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· 29th of 51
$1,318
AK $4,169TX $525
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.