How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,349 to $11,482Professionalmedian $1,380 · 10th to 90th $955 to $2,291
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 $1,348.96 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,348.96 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,348.96 | $1,412.54 | $1,412.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,168.69 Median $5,370.32 Typical High $12,882.50 | Facility | None | $4,168.69 | $5,370.32 | $12,882.50 |
BCBS Michigan Setting Professional Modifier None Typical Low $302.00 Median $1,819.70 Typical High $2,290.87 | Professional | None | $302.00 | $1,819.70 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $3,162.28 | Professional | None | $812.83 | $1,230.27 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $4,897.79 | Facility | None | $2,691.53 | $3,467.37 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,348.96 | $1,513.56 |
Priority Health Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $1,862.09 | Professional | None | $812.83 | $1,230.27 | $1,862.09 |
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 $1,122.02 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,258.93 | $1,412.54 |
9 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 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $977.24 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 50 · Both sides | $2,454.71 | $2,454.71 | $2,454.71 |
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 $204.17 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $141.25 |
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 7.6 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
$1,413
AK $4,266TX $562
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.