How much rates vary
Facilitymedian $7,943 · 10th to 90th $490 to $12,303Professionalmedian $2,630 · 10th to 90th $1,698 to $2,951
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 $2,691.53 Median $2,884.03 Typical High $6,918.31 | Facility | None | $2,691.53 | $2,884.03 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $2,884.03 | Professional | None | $2,511.89 | $2,754.23 | $2,884.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,943.28 Median $8,128.31 Typical High $14,125.38 | Facility | None | $7,943.28 | $8,128.31 | $14,125.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $575.44 Median $1,778.28 Typical High $2,884.03 | Professional | None | $575.44 | $1,778.28 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $6,456.54 | Professional | None | $1,584.89 | $2,454.71 | $6,456.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,691.53 Median $5,888.44 Typical High $6,309.57 | Facility | None | $2,691.53 | $5,888.44 | $6,309.57 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,187.76 | $2,754.23 | $3,235.94 |
Priority Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $3,019.95 | Professional | None | $1,584.89 | $2,454.71 | $3,019.95 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $3,467.37 | Professional | None | $2,137.96 | $2,570.40 | $3,467.37 |
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 $1,258.93 Median $1,380.38 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,258.93 | $1,380.38 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $549.54 Typical High $575.44 | Professional | 53 · Discontinued | $501.19 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,089.30 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,905.46 | $2,089.30 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $416.87 Typical High $426.58 | Professional | 55 · Aftercare only | $380.19 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $275.42 Typical High $288.40 | Professional | 56 · Pre-op care only | $251.19 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,949.84 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,949.84 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,318.26 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $537.03 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,995.26 | $2,089.30 | $2,089.30 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $398.11 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $269.15 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,949.84 | $1,949.84 |
Where Michigan sits
The same service costs 22.9 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· 22nd of 51
$2,692
AK $8,511TX $372
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.