How much rates vary
Facilitymedian $5,888 · 10th to 90th $501 to $9,333Professionalmedian $2,138 · 10th to 90th $468 to $2,344
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 $2,089.30 Median $2,089.30 Typical High $6,918.31 | Facility | None | $2,089.30 | $2,089.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,089.30 | $2,137.96 | $2,137.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $10,471.29 | Facility | None | $5,888.44 | $6,025.60 | $10,471.29 |
BCBS Michigan Setting Professional Modifier None Typical Low $467.74 Median $2,187.76 Typical High $2,290.87 | Professional | None | $467.74 | $2,187.76 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,862.09 | $3,235.94 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,089.30 Median $4,786.30 Typical High $4,897.79 | Facility | None | $2,089.30 | $4,786.30 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,659.59 | $2,089.30 | $2,344.23 |
Priority Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,778.28 | $3,019.95 |
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 $1,819.70 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,819.70 | $2,238.72 | $2,511.89 |
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 $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,047.13 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,548.82 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,548.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,445.44 |
Where Michigan sits
The same service costs 20.9 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· 21st of 51
$2,138
AK $5,370TX $257
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.