How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,230 to $8,511Professionalmedian $1,479 · 10th to 90th $1,000 to $2,291
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 $1,445.44 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,445.44 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,479.11 | $1,479.11 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $8,317.64 | Facility | None | $4,786.30 | $4,786.30 | $8,317.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $316.23 Median $1,698.24 Typical High $2,398.83 | Professional | None | $316.23 | $1,698.24 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $1,995.26 | Professional | None | $851.14 | $1,318.26 | $1,995.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,884.03 Median $5,011.87 Typical High $5,754.40 | Facility | None | $2,884.03 | $5,011.87 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,445.44 | $1,621.81 |
Priority Health Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,819.70 | Professional | None | $851.14 | $1,258.93 | $1,819.70 |
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 $1,148.15 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,288.25 | $1,621.81 |
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 $724.44 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,047.13 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 50 · Both sides | $2,570.40 | $2,570.40 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,047.13 |
Where Michigan sits
The same service costs 8.7 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
$1,479
AK $4,571TX $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.