How much rates vary
Facilitymedian $224 · 10th to 90th $138 to $2,692Professionalmedian $2,512 · 10th to 90th $1,148 to $3,020
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 $2,511.89 Median $2,511.89 Typical High $6,918.31 | Facility | None | $2,511.89 | $2,511.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,511.89 | $2,570.40 | $2,570.40 |
BCBS Michigan Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $257.04 | Facility | None | $138.04 | $138.04 | $257.04 |
BCBS Michigan Setting Professional Modifier None Typical Low $446.68 Median $1,380.38 Typical High $2,238.72 | Professional | None | $446.68 | $1,380.38 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $4,570.88 | Professional | None | $1,737.80 | $2,454.71 | $4,570.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,691.53 Median $5,623.41 Typical High $6,025.60 | Facility | None | $2,691.53 | $5,623.41 | $6,025.60 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,041.74 Median $2,691.53 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,691.53 | $2,818.38 |
Priority Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,238.72 | $3,801.89 |
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 $2,398.83 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,398.83 | $2,884.03 | $3,235.94 |
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 $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,258.93 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $501.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $251.19 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,778.28 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $537.03 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $1,862.09 |
Where Michigan sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 27th of 51
$2,512
AK $8,511KY $871
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.