How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,202 to $7,079Professionalmedian $2,042 · 10th to 90th $1,413 to $2,399
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 $2,041.74 Median $2,238.72 Typical High $6,918.31 | Facility | None | $2,041.74 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,187.76 | Professional | None | $1,659.59 | $2,137.96 | $2,187.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,348.96 | $2,238.72 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $4,897.79 | Professional | None | $1,202.26 | $1,905.46 | $4,897.79 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,238.72 Median $4,265.80 Typical High $6,918.31 | Facility | None | $2,238.72 | $4,265.80 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,621.81 | $2,041.74 | $2,398.83 |
Priority Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,862.09 | $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 $1,659.59 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,862.09 | $2,398.83 |
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 $954.99 Median $1,071.52 Typical High $1,096.48 | Professional | 52 · Reduced service | $954.99 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $426.58 Typical High $436.52 | Professional | 53 · Discontinued | $380.19 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $288.40 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $213.80 Typical High $218.78 | Professional | 56 · Pre-op care only | $190.55 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,513.56 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,023.29 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $407.38 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,513.56 | $1,584.89 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $302.00 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $1,479.11 |
Where Michigan sits
The same service costs 6.3 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· 30th of 51
$2,138
AK $6,457UT $1,023
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.