How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,202 to $7,079Professionalmedian $1,905 · 10th to 90th $1,445 to $2,138
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 $1,905.46 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,905.46 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,041.74 | Professional | None | $1,778.28 | $1,995.26 | $2,041.74 |
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 $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,949.84 | $2,041.74 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,905.46 | $3,019.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $5,754.40 | Facility | None | $2,187.76 | $3,801.89 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,862.09 | $2,041.74 |
Priority Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,949.84 | $3,019.95 |
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 $1,621.81 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,819.70 | $2,454.71 |
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 $891.25 Median $1,000.00 Typical High $1,023.29 | Professional | 52 · Reduced service | $891.25 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $398.11 Typical High $407.38 | Professional | 53 · Discontinued | $354.81 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,479.11 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,348.96 | $1,479.11 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $295.12 Typical High $309.03 | Professional | 55 · Aftercare only | $269.15 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $199.53 Typical High $204.17 | Professional | 56 · Pre-op care only | $181.97 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,380.38 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,380.38 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $954.99 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $380.19 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,412.54 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $281.84 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $190.55 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,380.38 | $1,380.38 |
Where Michigan sits
The same service costs 7.1 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· 30th of 51
$1,950
AK $6,026TX $851
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.