How much rates vary
Facilitymedian $4,266 · 10th to 90th $794 to $7,244Professionalmedian $813 · 10th to 90th $617 to $1,349
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 $776.25 Median $4,073.80 Typical High $5,754.40 | Facility | None | $776.25 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | None | $776.25 | $812.83 | $812.83 |
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 $177.83 Median $954.99 Typical High $1,348.96 | Professional | None | $177.83 | $954.99 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,621.81 | Professional | None | $467.74 | $724.44 | $1,621.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $4,897.79 | Facility | None | $1,548.82 | $1,621.81 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $870.96 | Professional | None | $616.60 | $776.25 | $870.96 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,096.48 | Professional | None | $467.74 | $707.95 | $1,096.48 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $794.33 | Professional | None | $630.96 | $724.44 | $794.33 |
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 $389.05 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $588.84 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $562.34 |
Where Michigan sits
The same service costs 8.1 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
$813
AK $2,512TX $309
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.