How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,122 to $7,413Professionalmedian $1,230 · 10th to 90th $234 to $2,089
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 $1,230.27 Median $1,288.25 Typical High $6,918.31 | Facility | None | $1,230.27 | $1,288.25 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,230.27 | $1,288.25 | $1,288.25 |
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 $234.42 Median $1,479.11 Typical High $2,089.30 | Professional | None | $234.42 | $1,479.11 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $3,162.28 | Professional | None | $741.31 | $1,148.15 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,454.71 Median $4,897.79 Typical High $5,011.87 | Facility | None | $2,454.71 | $4,897.79 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,230.27 | $1,412.54 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,698.24 | Professional | None | $741.31 | $1,148.15 | $1,698.24 |
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 $1,023.29 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,174.90 | $1,288.25 |
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 $616.60 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $616.60 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $933.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $912.01 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 50 · Both sides | $2,238.72 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $616.60 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $245.47 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $933.25 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $912.01 |
Where Michigan sits
The same service costs 7.9 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· 29th of 51
$1,288
AK $3,981TX $501
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.