How much rates vary
Facilitymedian $6,166 · 10th to 90th $501 to $9,550Professionalmedian $2,042 · 10th to 90th $1,549 to $3,020
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 $1,995.26 Median $2,041.74 Typical High $6,918.31 | Facility | None | $1,995.26 | $2,041.74 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,584.89 | $2,041.74 | $2,137.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,165.95 Median $6,309.57 Typical High $10,715.19 | Facility | None | $6,165.95 | $6,309.57 | $10,715.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $346.74 Median $2,041.74 Typical High $3,019.95 | Professional | None | $346.74 | $2,041.74 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,995.26 | $2,290.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,905.46 Median $4,786.30 Typical High $4,897.79 | Facility | None | $1,905.46 | $4,786.30 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,949.84 | $2,344.23 |
Priority Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,445.44 | $2,344.23 |
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 $1,778.28 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,778.28 | $2,290.87 | $2,754.23 |
13 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 $794.33 Median $1,023.29 Typical High $1,071.52 | Professional | 52 · Reduced service | $794.33 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $407.38 Typical High $426.58 | Professional | 53 · Discontinued | $323.59 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $309.03 Typical High $323.59 | Professional | 55 · Aftercare only | $239.88 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $204.17 Typical High $213.80 | Professional | 56 · Pre-op care only | $158.49 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,445.44 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,445.44 | $1,513.56 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Professional | 50 · Both sides | $3,235.94 | $3,235.94 | $4,365.16 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $954.99 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $380.19 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,445.44 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $288.40 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $190.55 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,380.38 | $1,380.38 |
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· 28th of 51
$2,042
AK $5,623TX $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.