How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,072 to $7,079Professionalmedian $1,585 · 10th to 90th $1,148 to $1,995
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 $1,698.24 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,698.24 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,621.81 | $1,778.28 | $1,778.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,168.69 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $398.11 Median $1,905.46 Typical High $1,995.26 | Professional | None | $398.11 | $1,905.46 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $4,168.69 | Professional | None | $1,000.00 | $1,548.82 | $4,168.69 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $5,754.40 | Facility | None | $2,570.40 | $3,019.95 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,513.56 | $1,862.09 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,513.56 | $2,570.40 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,445.44 | $1,995.26 |
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 $812.83 Median $870.96 Typical High $891.25 | Professional | 52 · Reduced service | $812.83 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $354.81 Typical High $363.08 | Professional | 53 · Discontinued | $323.59 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $263.03 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $1,230.27 |
Where Michigan sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 33rd of 51
$1,698
AK $5,495UT $933
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.