How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $4,467Professionalmedian $692 · 10th to 90th $537 to $955
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 $676.08 Median $870.96 Typical High $6,918.31 | Facility | None | $676.08 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $707.95 | Professional | None | $537.03 | $691.83 | $707.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,548.13 | Facility | None | $2,041.74 | $2,041.74 | $3,548.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $457.09 Median $794.33 Typical High $1,096.48 | Professional | None | $457.09 | $794.33 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $870.96 | Professional | None | $371.54 | $602.56 | $870.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $4,897.79 | Facility | None | $1,348.96 | $2,089.30 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $758.58 | Professional | None | $537.03 | $645.65 | $758.58 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $2,290.87 | Professional | None | $354.81 | $602.56 | $2,290.87 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $812.83 | Professional | None | $575.44 | $724.44 | $812.83 |
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 $269.15 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $407.38 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $501.19 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $128.82 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $478.63 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $66.07 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $467.74 |
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· 40th of 51
$724
AK $2,630TX $490
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.