How much rates vary
Facilitymedian $14,125 · 10th to 90th $501 to $21,878Professionalmedian $4,677 · 10th to 90th $1,047 to $5,495
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 $4,677.35 Median $4,677.35 Typical High $6,918.31 | Facility | None | $4,677.35 | $4,677.35 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,677.35 | $4,786.30 | $4,786.30 |
BCBS Michigan Setting Facility Modifier None Typical Low $14,125.38 Median $14,454.40 Typical High $24,547.09 | Facility | None | $14,125.38 | $14,454.40 | $24,547.09 |
BCBS Michigan Setting Professional Modifier None Typical Low $891.25 Median $3,090.30 Typical High $5,128.61 | Professional | None | $891.25 | $3,090.30 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $4,168.69 Typical High $7,413.10 | Professional | None | $2,691.53 | $4,168.69 | $7,413.10 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,677.35 Median $10,471.29 Typical High $11,748.98 | Facility | None | $4,677.35 | $10,471.29 | $11,748.98 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $5,623.41 | Professional | None | $3,981.07 | $4,677.35 | $5,623.41 |
Priority Health Setting Professional Modifier None Typical Low $2,818.38 Median $4,073.80 Typical High $6,918.31 | Professional | None | $2,818.38 | $4,073.80 | $6,918.31 |
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 $4,168.69 Median $5,128.61 Typical High $5,888.44 | Professional | None | $4,168.69 | $5,128.61 | $5,888.44 |
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 $2,344.23 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,344.23 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $933.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $3,467.37 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,311.31 | $3,311.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 52 · Reduced service | $2,344.23 | $2,344.23 | $2,344.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $933.25 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | 54 · Surgery only | $3,467.37 | $3,467.37 | $3,467.37 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $691.83 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $467.74 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,235.94 | $3,235.94 |
Where Michigan sits
The same service costs 21.9 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
$4,677
AK $12,303TX $562
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.