How much rates vary
Facilitymedian $2,884 · 10th to 90th $513 to $5,129Professionalmedian $1,000 · 10th to 90th $676 to $1,175
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 $1,023.29 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,023.29 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $5,128.61 | Facility | None | $2,884.03 | $2,951.21 | $5,128.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $194.98 Median $707.95 Typical High $1,148.15 | Professional | None | $194.98 | $707.95 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,621.81 | Professional | None | $660.69 | $912.01 | $1,621.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,398.83 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,148.15 | Professional | None | $812.83 | $1,000.00 | $1,148.15 |
Priority Health Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,445.44 | Professional | None | $630.96 | $870.96 | $1,445.44 |
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 $891.25 Median $1,122.02 Typical High $1,230.27 | Professional | None | $891.25 | $1,122.02 | $1,230.27 |
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 $501.19 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $501.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Michigan sits
The same service costs 5.9 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· 26th of 51
$1,000
AK $3,162TX $537
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.