How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,445 to $13,183Professionalmedian $2,239 · 10th to 90th $1,445 to $3,236
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 $2,137.96 Median $4,073.80 Typical High $5,754.40 | Facility | None | $2,137.96 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,137.96 | $2,238.72 | $2,238.72 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,011.87 Median $6,309.57 Typical High $15,488.17 | Facility | None | $5,011.87 | $6,309.57 | $15,488.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $467.74 Median $2,344.23 Typical High $3,467.37 | Professional | None | $467.74 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,995.26 | $2,884.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,162.28 Median $4,073.80 Typical High $5,128.61 | Facility | None | $3,162.28 | $4,073.80 | $5,128.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,737.80 | $2,187.76 | $2,454.71 |
Priority Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,698.24 | $2,691.53 |
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 $1,778.28 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,778.28 | $2,041.74 | $2,290.87 |
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 $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $323.59 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,548.82 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $3,715.35 Typical High $6,025.60 | Professional | 50 · Both sides | $3,715.35 | $3,715.35 | $6,025.60 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $323.59 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $213.80 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,548.82 |
Where Michigan sits
The same service costs 7.8 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· 26th of 51
$2,239
AK $6,761TX $871
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.