How much rates vary
Facilitymedian $4,898 · 10th to 90th $490 to $7,586Professionalmedian $1,820 · 10th to 90th $1,230 to $2,089
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 $1,819.70 Median $1,862.09 Typical High $4,897.79 | Facility | None | $1,819.70 | $1,862.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,862.09 | $1,905.46 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $8,511.38 | Facility | None | $4,897.79 | $4,897.79 | $8,511.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,905.46 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,737.80 | $2,137.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $4,897.79 | Facility | None | $1,513.56 | $3,801.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,737.80 | $2,137.96 |
Priority Health Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,137.96 | Professional | None | $954.99 | $1,288.25 | $2,137.96 |
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 $1,548.82 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,905.46 | $2,290.87 |
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 $724.44 Median $933.25 Typical High $954.99 | Professional | 52 · Reduced service | $724.44 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $371.54 Typical High $380.19 | Professional | 53 · Discontinued | $288.40 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,380.38 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,096.48 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $275.42 Typical High $288.40 | Professional | 55 · Aftercare only | $218.78 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $186.21 Typical High $190.55 | Professional | 56 · Pre-op care only | $144.54 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,288.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,288.25 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $870.96 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,258.93 |
Where Michigan sits
The same service costs 4.9 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
$1,820
AK $5,248TX $1,072
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.