How much rates vary
Facilitymedian $14,791 · 10th to 90th $501 to $22,909Professionalmedian $5,495 · 10th to 90th $3,802 to $6,026
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 $5,495.41 Typical High $6,918.31 | Facility | None | $4,897.79 | $5,495.41 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $5,495.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,495.41 | $5,623.41 | $5,623.41 |
BCBS Michigan Setting Facility Modifier None Typical Low $14,791.08 Median $15,135.61 Typical High $25,703.96 | Facility | None | $14,791.08 | $15,135.61 | $25,703.96 |
BCBS Michigan Setting Professional Modifier None Typical Low $3,630.78 Median $6,025.60 Typical High $6,025.60 | Professional | None | $3,630.78 | $6,025.60 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $4,897.79 Typical High $8,511.38 | Professional | None | $3,548.13 | $4,897.79 | $8,511.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,897.79 Median $10,000.00 Typical High $11,220.18 | Facility | None | $4,897.79 | $10,000.00 | $11,220.18 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,801.89 Median $5,011.87 Typical High $5,495.41 | Professional | None | $3,801.89 | $5,011.87 | $5,495.41 |
Priority Health Setting Professional Modifier None Typical Low $3,388.44 Median $4,677.35 Typical High $7,244.36 | Professional | None | $3,388.44 | $4,677.35 | $7,244.36 |
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 $4,677.35 Median $5,495.41 Typical High $6,025.60 | Professional | None | $4,677.35 | $5,495.41 | $6,025.60 |
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 $2,754.23 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,754.23 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $1,096.48 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $4,168.69 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $3,890.45 | $3,890.45 | $3,890.45 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,754.23 | $2,754.23 | $2,754.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $1,096.48 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | 54 · Surgery only | $4,073.80 | $4,073.80 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $812.83 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $549.54 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,801.89 | $3,801.89 | $3,801.89 |
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· 21st of 51
$5,495
AK $14,125TX $646
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.