How much rates vary
Facilitymedian $10,715 · 10th to 90th $501 to $16,596Professionalmedian $3,715 · 10th to 90th $2,570 to $4,365
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 $3,715.35 Median $3,715.35 Typical High $6,918.31 | Facility | None | $3,715.35 | $3,715.35 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
BCBS Michigan Setting Facility Modifier None Typical Low $10,715.19 Median $10,964.78 Typical High $18,620.87 | Facility | None | $10,715.19 | $10,964.78 | $18,620.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $707.95 Median $4,168.69 Typical High $4,168.69 | Professional | None | $707.95 | $4,168.69 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $5,888.44 | Professional | None | $2,089.30 | $3,162.28 | $5,888.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,630.78 Median $8,128.31 Typical High $9,120.11 | Facility | None | $3,630.78 | $8,128.31 | $9,120.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $4,365.16 | Professional | None | $3,090.30 | $3,630.78 | $4,365.16 |
Priority Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $5,495.41 | Professional | None | $2,238.72 | $3,162.28 | $5,495.41 |
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 $3,235.94 Median $4,168.69 Typical High $4,570.88 | Professional | None | $3,235.94 | $4,168.69 | $4,570.88 |
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 $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $741.31 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,754.23 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $1,819.70 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $724.44 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,754.23 | $2,754.23 | $2,754.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $549.54 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,570.40 | $2,570.40 |
Where Michigan sits
The same service costs 5.1 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· 22nd of 51
$3,715
AK $9,772TX $1,905
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.