How much rates vary
Facilitymedian $12,303 · 10th to 90th $501 to $19,055Professionalmedian $4,467 · 10th to 90th $3,548 to $5,370
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 $4,466.84 Median $4,570.88 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,570.88 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $4,570.88 Typical High $4,786.30 | Professional | None | $3,548.13 | $4,570.88 | $4,786.30 |
BCBS Michigan Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $21,379.62 | Facility | None | $12,302.69 | $12,302.69 | $21,379.62 |
BCBS Michigan Setting Professional Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $4,570.88 | Professional | None | $2,754.23 | $4,570.88 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $5,128.61 | Professional | None | $2,511.89 | $4,365.16 | $5,128.61 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,265.80 Median $9,332.54 Typical High $10,471.29 | Facility | None | $4,265.80 | $9,332.54 | $10,471.29 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $5,248.07 | Professional | None | $3,548.13 | $4,265.80 | $5,248.07 |
Priority Health Setting Professional Modifier None Typical Low $2,344.23 Median $4,365.16 Typical High $6,456.54 | Professional | None | $2,344.23 | $4,365.16 | $6,456.54 |
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 $3,981.07 Median $5,011.87 Typical High $6,025.60 | Professional | None | $3,981.07 | $5,011.87 | $6,025.60 |
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 $1,778.28 Median $2,290.87 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,778.28 | $2,290.87 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $912.01 Typical High $954.99 | Professional | 53 · Discontinued | $707.95 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $3,467.37 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,691.53 | $3,467.37 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $691.83 Typical High $707.95 | Professional | 55 · Aftercare only | $537.03 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $457.09 Typical High $478.63 | Professional | 56 · Pre-op care only | $354.81 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $3,235.94 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,511.89 | $3,235.94 | $3,311.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $2,137.96 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $851.14 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $3,235.94 | $3,311.31 | $3,311.31 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $645.65 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $426.58 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,019.95 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $3,019.95 | $3,090.30 | $3,090.30 |
Where Michigan sits
The same service costs 7.1 times more in Alaska than in Arkansas. 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· 19th of 51
$4,571
AK $12,882AR $1,820
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.