How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $7,079Professionalmedian $2,239 · 10th to 90th $1,549 to $2,455
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 $2,187.76 Median $2,884.03 Typical High $4,897.79 | Facility | None | $2,187.76 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,344.23 | Professional | None | $2,089.30 | $2,238.72 | $2,344.23 |
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 $1,445.44 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,445.44 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $5,495.41 | Professional | None | $1,288.25 | $2,290.87 | $5,495.41 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $5,128.61 | Facility | None | $2,570.40 | $2,884.03 | $5,128.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,737.80 | $2,238.72 | $2,691.53 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,949.84 | $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 $1,778.28 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,778.28 | $2,089.30 | $2,884.03 |
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 $1,047.13 Median $1,122.02 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,047.13 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $446.68 Typical High $467.74 | Professional | 53 · Discontinued | $416.87 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,698.24 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,548.82 | $1,698.24 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $338.84 Typical High $346.74 | Professional | 55 · Aftercare only | $309.03 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $223.87 Typical High $234.42 | Professional | 56 · Pre-op care only | $208.93 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,584.89 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,584.89 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,096.48 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $436.52 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,621.81 | $1,698.24 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,584.89 | $1,584.89 |
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· 31st of 51
$2,239
AK $7,079TX $1,000
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.