How much rates vary
Facilitymedian $8,128 · 10th to 90th $501 to $12,589Professionalmedian $3,090 · 10th to 90th $2,042 to $3,548
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 $3,235.94 Median $3,311.31 Typical High $6,918.31 | Facility | None | $3,235.94 | $3,311.31 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $3,467.37 | Professional | None | $2,630.27 | $3,311.31 | $3,467.37 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $14,125.38 | Facility | None | $8,128.31 | $8,128.31 | $14,125.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $562.34 Median $3,162.28 Typical High $3,311.31 | Professional | None | $562.34 | $3,162.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $4,168.69 | Professional | None | $1,819.70 | $2,951.21 | $4,168.69 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,090.30 Median $6,456.54 Typical High $7,079.46 | Facility | None | $3,090.30 | $6,456.54 | $7,079.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,398.83 | $3,019.95 | $3,388.44 |
Priority Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,698.24 | $2,511.89 | $4,168.69 |
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 $2,884.03 Typical High $3,630.78 | Professional | None | $2,089.30 | $2,884.03 | $3,630.78 |
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 $1,318.26 Median $1,659.59 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,318.26 | $1,659.59 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $660.69 Typical High $691.83 | Professional | 53 · Discontinued | $524.81 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,511.89 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,949.84 | $2,511.89 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $501.19 Typical High $524.81 | Professional | 55 · Aftercare only | $389.05 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $331.13 Typical High $346.74 | Professional | 56 · Pre-op care only | $263.03 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,344.23 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,344.23 | $2,454.71 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,548.82 | $1,621.81 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $616.60 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,344.23 | $2,398.83 | $2,398.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $467.74 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $309.03 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,238.72 | $2,238.72 |
Where Michigan sits
The same service costs 6.2 times more in Alaska than in Delaware. 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· 18th of 51
$3,162
AK $9,333DE $1,514
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.