How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,349 to $8,318Professionalmedian $1,622 · 10th to 90th $1,096 to $2,042
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 $1,548.82 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,548.82 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,548.82 | $1,621.81 | $1,698.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $7,762.47 | Facility | None | $4,466.84 | $4,466.84 | $7,762.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,737.80 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,137.96 | Professional | None | $933.25 | $1,445.44 | $2,137.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,162.28 Median $5,128.61 Typical High $5,754.40 | Facility | None | $3,162.28 | $5,128.61 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,621.81 | $1,778.28 |
Priority Health Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,949.84 | Professional | None | $933.25 | $1,445.44 | $1,949.84 |
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 $1,258.93 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,479.11 | $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 $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,122.02 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 50 · Both sides | $2,754.23 | $2,754.23 | $2,754.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,122.02 |
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· 25th of 51
$1,622
AK $5,012TX $575
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.