How much rates vary
Facilitymedian $11,482 · 10th to 90th $501 to $17,783Professionalmedian $3,890 · 10th to 90th $2,754 to $4,571
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 $3,981.07 Median $4,265.80 Typical High $6,918.31 | Facility | None | $3,981.07 | $4,265.80 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $4,265.80 | Professional | None | $3,548.13 | $4,265.80 | $4,265.80 |
BCBS Michigan Setting Facility Modifier None Typical Low $11,481.54 Median $11,748.98 Typical High $19,952.62 | Facility | None | $11,481.54 | $11,748.98 | $19,952.62 |
BCBS Michigan Setting Professional Modifier None Typical Low $741.31 Median $2,754.23 Typical High $4,365.16 | Professional | None | $741.31 | $2,754.23 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $4,073.80 Typical High $8,912.51 | Professional | None | $2,398.83 | $4,073.80 | $8,912.51 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,890.45 Median $8,709.64 Typical High $9,772.37 | Facility | None | $3,890.45 | $8,709.64 | $9,772.37 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,311.31 Median $4,073.80 Typical High $5,128.61 | Professional | None | $3,311.31 | $4,073.80 | $5,128.61 |
Priority Health Setting Professional Modifier None Typical Low $2,398.83 Median $4,073.80 Typical High $4,897.79 | Professional | None | $2,398.83 | $4,073.80 | $4,897.79 |
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 $3,162.28 Median $3,801.89 Typical High $5,128.61 | Professional | None | $3,162.28 | $3,801.89 | $5,128.61 |
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 $1,778.28 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,778.28 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $707.95 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,630.27 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $524.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,951.21 | $2,951.21 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,949.84 | $2,041.74 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $776.25 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,951.21 | $3,019.95 | $3,019.95 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $588.84 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $389.05 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,818.38 | $2,818.38 |
Where Michigan sits
The same service costs 12.6 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· 21st of 51
$3,981
AK $12,023TX $955
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.