How much rates vary
Facilitymedian $7,413 · 10th to 90th $501 to $11,482Professionalmedian $2,692 · 10th to 90th $1,660 to $3,236
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 $2,691.53 Median $2,754.23 Typical High $6,918.31 | Facility | None | $2,691.53 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,754.23 | $2,884.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $12,882.50 | Facility | None | $7,413.10 | $7,413.10 | $12,882.50 |
BCBS Michigan Setting Professional Modifier None Typical Low $478.63 Median $2,691.53 Typical High $2,818.38 | Professional | None | $478.63 | $2,691.53 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $3,162.28 | Professional | None | $1,513.56 | $2,511.89 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $6,025.60 Typical High $6,606.93 | Facility | None | $2,570.40 | $6,025.60 | $6,606.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,570.40 | $3,162.28 |
Priority Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $3,981.07 | Professional | None | $1,445.44 | $2,511.89 | $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 $2,398.83 Median $3,090.30 Typical High $3,467.37 | Professional | None | $2,398.83 | $3,090.30 | $3,467.37 |
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 $1,071.52 Median $1,380.38 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,071.52 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $549.54 Typical High $575.44 | Professional | 53 · Discontinued | $436.52 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,089.30 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,621.81 | $2,089.30 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $416.87 Typical High $436.52 | Professional | 55 · Aftercare only | $323.59 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $275.42 Typical High $288.40 | Professional | 56 · Pre-op care only | $218.78 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,949.84 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,949.84 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,288.25 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,949.84 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $389.05 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,862.09 | $1,862.09 |
Where Michigan sits
The same service costs 6.2 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· 25th of 51
$2,692
AK $7,762TX $1,259
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.