How much rates vary
Facilitymedian $6,310 · 10th to 90th $501 to $10,000Professionalmedian $2,291 · 10th to 90th $1,549 to $2,570
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 $2,238.72 Median $2,238.72 Typical High $6,918.31 | Facility | None | $2,238.72 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,238.72 | $2,290.87 | $2,290.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,309.57 Median $6,456.54 Typical High $11,220.18 | Facility | None | $6,309.57 | $6,456.54 | $11,220.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,548.82 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,479.11 | $1,995.26 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,238.72 Median $4,897.79 Typical High $5,248.07 | Facility | None | $2,238.72 | $4,897.79 | $5,248.07 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,778.28 | $2,238.72 | $2,511.89 |
Priority Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,905.46 | $3,235.94 |
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 $1,995.26 Median $2,454.71 Typical High $2,691.53 | Professional | None | $1,995.26 | $2,454.71 | $2,691.53 |
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 $1,122.02 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,122.02 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,659.59 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,584.89 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $446.68 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,548.82 |
Where Michigan sits
The same service costs 5.4 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
$2,291
AK $5,888TX $1,096
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.