How much rates vary
Facilitymedian $6,457 · 10th to 90th $501 to $10,000Professionalmedian $2,399 · 10th to 90th $1,622 to $3,802
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 $2,398.83 Median $2,454.71 Typical High $6,918.31 | Facility | None | $2,398.83 | $2,454.71 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,454.71 | $2,511.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $11,220.18 | Facility | None | $6,456.54 | $6,456.54 | $11,220.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $478.63 Median $2,511.89 Typical High $3,801.89 | Professional | None | $478.63 | $2,511.89 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,348.96 | $2,344.23 | $2,818.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,290.87 Median $5,248.07 Typical High $5,754.40 | Facility | None | $2,290.87 | $5,248.07 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,949.84 | $2,290.87 | $2,818.38 |
Priority Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,698.24 | $2,818.38 |
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 $2,089.30 Median $2,691.53 Typical High $3,090.30 | Professional | None | $2,089.30 | $2,691.53 | $3,090.30 |
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 $954.99 Median $1,230.27 Typical High $1,258.93 | Professional | 52 · Reduced service | $954.99 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $489.78 Typical High $512.86 | Professional | 53 · Discontinued | $389.05 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,819.70 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,445.44 | $1,819.70 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $363.08 Typical High $380.19 | Professional | 55 · Aftercare only | $288.40 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $245.47 Typical High $251.19 | Professional | 56 · Pre-op care only | $190.55 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,698.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,698.24 | $1,778.28 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,148.15 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $457.09 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,737.80 | $1,778.28 | $1,778.28 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $346.74 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,659.59 | $1,659.59 |
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· 23rd of 51
$2,455
AK $6,918TX $1,202
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.