How much rates vary
Facilitymedian $5,888 · 10th to 90th $501 to $9,333Professionalmedian $2,138 · 10th to 90th $1,413 to $2,512
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 $2,137.96 Median $2,187.76 Typical High $6,918.31 | Facility | None | $2,137.96 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,290.87 | Professional | None | $1,737.80 | $2,187.76 | $2,290.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $10,232.93 | Facility | None | $5,888.44 | $6,025.60 | $10,232.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $389.05 Median $2,290.87 Typical High $2,290.87 | Professional | None | $389.05 | $2,290.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,202.26 | $2,137.96 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,041.74 Median $4,897.79 Typical High $5,128.61 | Facility | None | $2,041.74 | $4,897.79 | $5,128.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,737.80 | $2,089.30 | $2,511.89 |
Priority Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,548.82 | $2,511.89 |
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 $1,862.09 Median $2,398.83 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,398.83 | $2,754.23 |
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 $870.96 Median $1,096.48 Typical High $1,148.15 | Professional | 52 · Reduced service | $870.96 | $1,096.48 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $436.52 Typical High $457.09 | Professional | 53 · Discontinued | $346.74 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,659.59 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,288.25 | $1,659.59 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $331.13 Typical High $346.74 | Professional | 55 · Aftercare only | $263.03 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $218.78 Typical High $229.09 | Professional | 56 · Pre-op care only | $173.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,548.82 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,548.82 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,023.29 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $416.87 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,548.82 | $1,621.81 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $309.03 | $323.59 | $323.59 |
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 $1,445.44 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,513.56 | $1,513.56 |
Where Michigan sits
The same service costs 5.6 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
$2,188
AK $6,166TX $1,096
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.