How much rates vary
Facilitymedian $7,943 · 10th to 90th $501 to $12,303Professionalmedian $2,884 · 10th to 90th $676 to $3,388
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 $2,951.21 Median $2,951.21 Typical High $6,918.31 | Facility | None | $2,951.21 | $2,951.21 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,951.21 | $3,019.95 | $3,019.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $13,803.84 | Facility | None | $7,943.28 | $7,943.28 | $13,803.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $575.44 Median $2,089.30 Typical High $3,388.44 | Professional | None | $575.44 | $2,089.30 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $4,786.30 | Professional | None | $1,905.46 | $2,570.40 | $4,786.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,951.21 Median $5,370.32 Typical High $5,888.44 | Facility | None | $2,951.21 | $5,370.32 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $2,951.21 | Professional | None | $1,995.26 | $2,630.27 | $2,951.21 |
Priority Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,511.89 | $3,890.45 |
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 $2,511.89 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,511.89 | $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 $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,479.11 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,238.72 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $295.12 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,137.96 | $2,137.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $588.84 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,187.76 | $2,187.76 | $2,187.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $2,041.74 |
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
$2,884
AK $7,586TX $363
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.