How much rates vary
Facilitymedian $12,303 · 10th to 90th $1,202 to $19,055Professionalmedian $4,169 · 10th to 90th $3,162 to $7,586
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 $4,897.79 Median $4,897.79 Typical High $6,918.31 | Facility | None | $4,897.79 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $4,897.79 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,897.79 | $5,011.87 | $5,011.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $21,379.62 | Facility | None | $12,302.69 | $12,302.69 | $21,379.62 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,047.13 Median $5,248.07 Typical High $7,943.28 | Professional | None | $1,047.13 | $5,248.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $4,265.80 Typical High $6,025.60 | Professional | None | $2,951.21 | $4,265.80 | $6,025.60 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,897.79 Median $5,011.87 Typical High $9,332.54 | Facility | None | $4,897.79 | $5,011.87 | $9,332.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,162.28 Median $4,073.80 Typical High $5,011.87 | Professional | None | $3,162.28 | $4,073.80 | $5,011.87 |
Priority Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $5,011.87 | Professional | None | $2,951.21 | $3,801.89 | $5,011.87 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,912.51 | Facility | None | $851.14 | $2,238.72 | $8,912.51 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $4,265.80 Typical High $4,897.79 | Professional | None | $3,715.35 | $4,265.80 | $4,897.79 |
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 $2,398.83 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,398.83 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $977.24 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,630.78 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $489.78 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $3,388.44 | $3,548.13 | $3,548.13 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | 50 · Both sides | $8,511.38 | $8,511.38 | $8,511.38 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2,454.71 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,454.71 | $2,511.89 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $977.24 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,630.78 | $3,801.89 | $3,801.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $489.78 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $3,388.44 | $3,548.13 | $3,548.13 |
Where Michigan sits
The same service costs 20.4 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· 35th of 51
$4,266
AK $15,488TX $759
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.