How much rates vary
Facilitymedian $17,783 · 10th to 90th $501 to $27,542Professionalmedian $5,754 · 10th to 90th $1,288 to $6,761
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 $4,897.79 Median $5,754.40 Typical High $6,918.31 | Facility | None | $4,897.79 | $5,754.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $5,754.40 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,754.40 | $5,888.44 | $5,888.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $30,902.95 | Facility | None | $17,782.79 | $17,782.79 | $30,902.95 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $6,456.54 | Professional | None | $1,288.25 | $4,073.80 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $5,128.61 Typical High $9,120.11 | Professional | None | $2,818.38 | $5,128.61 | $9,120.11 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,897.79 Median $13,182.57 Typical High $14,454.40 | Facility | None | $4,897.79 | $13,182.57 | $14,454.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5,011.87 Median $5,754.40 Typical High $7,079.46 | Professional | None | $5,011.87 | $5,754.40 | $7,079.46 |
Priority Health Setting Professional Modifier None Typical Low $3,548.13 Median $5,011.87 Typical High $8,912.51 | Professional | None | $3,548.13 | $5,011.87 | $8,912.51 |
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 $5,128.61 Median $6,309.57 Typical High $7,585.78 | Professional | None | $5,128.61 | $6,309.57 | $7,585.78 |
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 $2,884.03 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,884.03 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $1,148.15 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,365.16 Median $4,466.84 Typical High $4,466.84 | Professional | 54 · Surgery only | $4,365.16 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 55 · Aftercare only | $870.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $575.44 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,073.80 Median $4,168.69 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $4,073.80 | $4,168.69 | $4,168.69 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,884.03 | $2,884.03 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $1,148.15 | $1,148.15 | $1,148.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $4,365.16 | $4,365.16 | $4,365.16 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $870.96 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $575.44 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $4,073.80 | $4,073.80 | $4,073.80 |
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
$5,754
AK $15,136TX $692
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.