How much rates vary
Facilitymedian $7,079 · 10th to 90th $501 to $10,965Professionalmedian $2,291 · 10th to 90th $1,820 to $2,951
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 $2,290.87 Median $2,344.23 Typical High $6,918.31 | Facility | None | $2,290.87 | $2,344.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $2,454.71 | Professional | None | $1,819.70 | $2,344.23 | $2,454.71 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,079.46 Median $7,244.36 Typical High $12,589.25 | Facility | None | $7,079.46 | $7,244.36 | $12,589.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,348.96 | $2,290.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,288.25 | $2,290.87 | $2,630.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,187.76 Median $5,370.32 Typical High $5,888.44 | Facility | None | $2,187.76 | $5,370.32 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,238.72 | $2,818.38 |
Priority Health Setting Professional Modifier None Typical Low $1,202.26 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,202.26 | $2,290.87 | $3,235.94 |
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 $2,041.74 Median $2,754.23 Typical High $3,162.28 | Professional | None | $2,041.74 | $2,754.23 | $3,162.28 |
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 $912.01 Median $1,174.90 Typical High $1,230.27 | Professional | 52 · Reduced service | $912.01 | $1,174.90 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $467.74 Typical High $489.78 | Professional | 53 · Discontinued | $363.08 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,737.80 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,380.38 | $1,737.80 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $346.74 Typical High $363.08 | Professional | 55 · Aftercare only | $275.42 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $234.42 Typical High $245.47 | Professional | 56 · Pre-op care only | $181.97 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,621.81 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,621.81 | $1,698.24 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 50 · Both sides | $2,454.71 | $2,454.71 | $2,454.71 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,096.48 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $436.52 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,621.81 | $1,698.24 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $323.59 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $218.78 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,584.89 | $1,584.89 |
Where Michigan sits
The same service costs 5.8 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
$2,291
AK $6,457TX $1,122
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.