How much rates vary
Facilitymedian $13,490 · 10th to 90th $501 to $20,893Professionalmedian $4,677 · 10th to 90th $1,122 to $5,623
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 $5,128.61 Typical High $6,918.31 | Facility | None | $4,897.79 | $5,128.61 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
BCBS Michigan Setting Facility Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $23,442.29 | Facility | None | $13,489.63 | $13,489.63 | $23,442.29 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,122.02 Median $3,311.31 Typical High $5,623.41 | Professional | None | $1,122.02 | $3,311.31 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $4,466.84 Typical High $7,943.28 | Professional | None | $3,311.31 | $4,466.84 | $7,943.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,897.79 Median $9,120.11 Typical High $10,232.93 | Facility | None | $4,897.79 | $9,120.11 | $10,232.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $5,011.87 | Professional | None | $3,467.37 | $4,570.88 | $5,011.87 |
Priority Health Setting Professional Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $6,606.93 | Professional | None | $3,162.28 | $4,365.16 | $6,606.93 |
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 $4,365.16 Median $5,128.61 Typical High $5,888.44 | Professional | None | $4,365.16 | $5,128.61 | $5,888.44 |
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 $2,511.89 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,511.89 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,801.89 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,801.89 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $758.58 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,548.13 | $3,630.78 | $3,630.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,511.89 | $2,511.89 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $1,000.00 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,801.89 | $3,801.89 | $3,801.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $758.58 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $501.19 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $3,548.13 | $3,548.13 | $3,548.13 |
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· 24th of 51
$4,677
AK $13,183TX $603
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.