How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,047 to $6,918Professionalmedian $708 · 10th to 90th $575 to $813
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 $676.08 Median $2,884.03 Typical High $4,897.79 | Facility | None | $676.08 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | None | $676.08 | $707.95 | $707.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $6,456.54 | Facility | None | $3,715.35 | $3,715.35 | $6,456.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $131.83 Median $776.25 Typical High $812.83 | Professional | None | $131.83 | $776.25 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $1,230.27 | Professional | None | $426.58 | $630.96 | $1,230.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,818.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $812.83 | Professional | None | $575.44 | $707.95 | $812.83 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,000.00 | Professional | None | $407.38 | $630.96 | $1,000.00 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,120.11 | Facility | None | $891.25 | $2,818.38 | $9,120.11 |
United Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $812.83 | Professional | None | $575.44 | $707.95 | $812.83 |
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 $338.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $134.90 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $70.79 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $489.78 |
Where Michigan sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 33rd of 51
$724
AK $2,188UT $331
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.