How much rates vary
Facilitymedian $6,607 · 10th to 90th $501 to $10,471Professionalmedian $2,399 · 10th to 90th $1,585 to $2,951
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 $2,454.71 Median $2,511.89 Typical High $6,918.31 | Facility | None | $2,454.71 | $2,511.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $2,570.40 | Professional | None | $1,949.84 | $2,511.89 | $2,570.40 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,606.93 Median $6,760.83 Typical High $11,481.54 | Facility | None | $6,606.93 | $6,760.83 | $11,481.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $426.58 Median $1,584.89 Typical High $2,511.89 | Professional | None | $426.58 | $1,584.89 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,380.38 | $2,344.23 | $2,818.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,344.23 Median $5,248.07 Typical High $5,754.40 | Facility | None | $2,344.23 | $5,248.07 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,344.23 | $2,951.21 |
Priority Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,737.80 | $2,818.38 |
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 $2,137.96 Median $2,754.23 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,754.23 | $3,162.28 |
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 $977.24 Median $1,258.93 Typical High $1,288.25 | Professional | 52 · Reduced service | $977.24 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $501.19 Typical High $524.81 | Professional | 53 · Discontinued | $389.05 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,862.09 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,479.11 | $1,862.09 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $371.54 Typical High $389.05 | Professional | 55 · Aftercare only | $295.12 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $251.19 Typical High $257.04 | Professional | 56 · Pre-op care only | $194.98 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,737.80 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,737.80 | $1,819.70 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,174.90 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $467.74 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,737.80 | $1,819.70 | $1,819.70 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $234.42 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,698.24 | $1,698.24 |
Where Michigan sits
The same service costs 5.5 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
$2,455
AK $6,918TX $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.