How much rates vary
Facilitymedian $7,762 · 10th to 90th $501 to $12,023Professionalmedian $2,818 · 10th to 90th $1,862 to $3,467
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 $2,884.03 Median $2,951.21 Typical High $6,918.31 | Facility | None | $2,884.03 | $2,951.21 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $3,019.95 | Professional | None | $2,290.87 | $2,951.21 | $3,019.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,762.47 Median $7,943.28 Typical High $13,489.63 | Facility | None | $7,762.47 | $7,943.28 | $13,489.63 |
BCBS Michigan Setting Professional Modifier None Typical Low $588.84 Median $1,862.09 Typical High $2,951.21 | Professional | None | $588.84 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,818.38 | $3,311.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,754.23 Median $6,025.60 Typical High $6,606.93 | Facility | None | $2,754.23 | $6,025.60 | $6,606.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,754.23 | $3,388.44 |
Priority Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,513.56 | $2,041.74 | $3,311.31 |
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 $2,511.89 Median $3,235.94 Typical High $3,630.78 | Professional | None | $2,511.89 | $3,235.94 | $3,630.78 |
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 $1,148.15 Median $1,445.44 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,148.15 | $1,445.44 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $588.84 Typical High $602.56 | Professional | 53 · Discontinued | $457.09 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,187.76 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,698.24 | $2,187.76 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $436.52 Typical High $457.09 | Professional | 55 · Aftercare only | $338.84 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $295.12 Typical High $302.00 | Professional | 56 · Pre-op care only | $229.09 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,041.74 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,041.74 | $2,137.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,380.38 | $1,412.54 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $549.54 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,041.74 | $2,137.96 | $2,137.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $407.38 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $275.42 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,995.26 | $1,995.26 |
Where Michigan sits
The same service costs 5.2 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· 27th of 51
$2,818
AK $8,128TX $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.