How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,349 to $9,120Professionalmedian $2,042 · 10th to 90th $1,288 to $3,162
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 $1,949.84 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,949.84 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,949.84 | $2,041.74 | $2,041.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,495.41 Median $5,623.41 Typical High $9,772.37 | Facility | None | $5,495.41 | $5,623.41 | $9,772.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,288.25 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,819.70 | $2,691.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,778.28 | $4,073.80 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,995.26 | $2,187.76 |
Priority Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,584.89 | $2,454.71 |
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 $1,096.48 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,698.24 | $2,041.74 |
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 $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $977.24 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,479.11 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $295.12 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,445.44 | $1,445.44 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | 50 · Both sides | $3,467.37 | $3,467.37 | $3,467.37 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $977.24 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $389.05 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,479.11 | $1,513.56 | $1,513.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $295.12 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $194.98 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,412.54 | $1,412.54 |
Where Michigan sits
The same service costs 8.5 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· 21st of 51
$2,042
AK $6,166TX $724
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.