How much rates vary
Facilitymedian $6,761 · 10th to 90th $501 to $10,471Professionalmedian $2,399 · 10th to 90th $513 to $2,630
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 $2,344.23 Median $2,344.23 Typical High $6,918.31 | Facility | None | $2,344.23 | $2,344.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,344.23 | $2,398.83 | $2,398.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $11,748.98 | Facility | None | $6,760.83 | $6,760.83 | $11,748.98 |
BCBS Michigan Setting Professional Modifier None Typical Low $512.86 Median $2,570.40 Typical High $2,570.40 | Professional | None | $512.86 | $2,570.40 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,548.82 | $2,089.30 | $3,630.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,344.23 Median $5,011.87 Typical High $5,495.41 | Facility | None | $2,344.23 | $5,011.87 | $5,495.41 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,344.23 | $2,630.27 |
Priority Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,995.26 | $3,388.44 |
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 $2,041.74 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,570.40 | $2,818.38 |
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 $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,174.90 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,737.80 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $467.74 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,737.80 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,621.81 |
Where Michigan sits
The same service costs 5.4 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· 23rd of 51
$2,399
AK $6,166TX $1,148
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.