How much rates vary
Facilitymedian $9,333 · 10th to 90th $501 to $14,454Professionalmedian $3,311 · 10th to 90th $2,188 to $3,890
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 $3,388.44 Median $3,467.37 Typical High $6,918.31 | Facility | None | $3,388.44 | $3,467.37 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $3,630.78 | Professional | None | $2,691.53 | $3,467.37 | $3,630.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $16,218.10 | Facility | None | $9,332.54 | $9,332.54 | $16,218.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $660.69 Median $3,311.31 Typical High $3,548.13 | Professional | None | $660.69 | $3,311.31 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $3,235.94 Typical High $3,981.07 | Professional | None | $1,905.46 | $3,235.94 | $3,981.07 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,235.94 Median $7,079.46 Typical High $7,943.28 | Facility | None | $3,235.94 | $7,079.46 | $7,943.28 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,691.53 | $3,235.94 | $3,981.07 |
Priority Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,778.28 | $2,454.71 | $3,981.07 |
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 $2,630.27 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,630.27 | $3,162.28 | $4,168.69 |
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 $1,348.96 Median $1,737.80 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,348.96 | $1,737.80 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $691.83 Typical High $724.44 | Professional | 53 · Discontinued | $549.54 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,630.27 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,041.74 | $2,630.27 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $524.81 Typical High $549.54 | Professional | 55 · Aftercare only | $407.38 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $346.74 Typical High $363.08 | Professional | 56 · Pre-op care only | $269.15 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,454.71 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,454.71 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,621.81 | $1,698.24 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $645.65 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,454.71 | $2,511.89 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $489.78 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $323.59 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,344.23 | $2,344.23 |
Where Michigan sits
The same service costs 6.3 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· 17th of 51
$3,388
AK $9,772TX $1,549
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.