How much rates vary
Facilitymedian $8,511 · 10th to 90th $501 to $13,183Professionalmedian $2,951 · 10th to 90th $1,905 to $3,631
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 $2,951.21 Median $3,019.95 Typical High $6,918.31 | Facility | None | $2,951.21 | $3,019.95 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $3,162.28 | Professional | None | $2,344.23 | $3,019.95 | $3,162.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $14,791.08 | Facility | None | $8,511.38 | $8,511.38 | $14,791.08 |
BCBS Michigan Setting Professional Modifier None Typical Low $602.56 Median $2,884.03 Typical High $3,019.95 | Professional | None | $602.56 | $2,884.03 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,754.23 | $3,388.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,818.38 Median $6,456.54 Typical High $7,079.46 | Facility | None | $2,818.38 | $6,456.54 | $7,079.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,398.83 | $2,818.38 | $3,467.37 |
Priority Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,548.82 | $2,089.30 | $3,388.44 |
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 $2,570.40 Median $3,311.31 Typical High $3,801.89 | Professional | None | $2,570.40 | $3,311.31 | $3,801.89 |
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 $1,174.90 Median $1,513.56 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,174.90 | $1,513.56 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $602.56 Typical High $630.96 | Professional | 53 · Discontinued | $467.74 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,238.72 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,778.28 | $2,238.72 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $446.68 Typical High $467.74 | Professional | 55 · Aftercare only | $354.81 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $302.00 Typical High $316.23 | Professional | 56 · Pre-op care only | $234.42 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,089.30 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,089.30 | $2,187.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,412.54 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $562.34 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,089.30 | $2,187.76 | $2,187.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $281.84 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,041.74 | $2,041.74 |
Where Michigan sits
The same service costs 5.4 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· 24th of 51
$2,951
AK $8,318TX $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.