How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,288 to $12,589Professionalmedian $1,349 · 10th to 90th $912 to $2,138
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 $1,288.25 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,288.25 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,348.96 | $1,348.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,943.28 Median $8,128.31 Typical High $13,803.84 | Facility | None | $7,943.28 | $8,128.31 | $13,803.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $245.47 Median $1,445.44 Typical High $2,137.96 | Professional | None | $245.47 | $1,445.44 | $2,137.96 |
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 $776.25 Median $1,202.26 Typical High $1,778.28 | Professional | None | $776.25 | $1,202.26 | $1,778.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $5,011.87 Typical High $5,754.40 | Facility | None | $2,570.40 | $5,011.87 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,288.25 | $1,445.44 |
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 $776.25 Median $1,174.90 Typical High $1,621.81 | Professional | None | $776.25 | $1,174.90 | $1,621.81 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $891.25 | $2,818.38 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,202.26 | $1,348.96 |
13 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 $645.65 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $933.25 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 50 · Both sides | $2,290.87 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $933.25 |
Where Michigan sits
The same service costs 8.5 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· 27th of 51
$1,349
AK $4,074TX $479
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.