How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,230 to $6,761Professionalmedian $1,318 · 10th to 90th $813 to $2,239
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 $1,318.26 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,318.26 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,380.38 | $1,380.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,311.31 Median $3,388.44 Typical High $5,754.40 | Facility | None | $3,311.31 | $3,388.44 | $5,754.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $295.12 Median $1,584.89 Typical High $2,238.72 | Professional | None | $295.12 | $1,584.89 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,819.70 | Professional | None | $794.33 | $1,230.27 | $1,819.70 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $5,754.40 | Facility | None | $1,778.28 | $2,754.23 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,318.26 | $1,479.11 |
Priority Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,659.59 | Professional | None | $794.33 | $1,071.52 | $1,659.59 |
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 $1,047.13 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,174.90 | $1,318.26 |
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 $660.69 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $269.15 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $977.24 |
Where Michigan sits
The same service costs 18.2 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
$1,349
AK $4,266TX $234
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.