How much rates vary
Facilitymedian $2,455 · 10th to 90th $851 to $4,571Professionalmedian $1,349 · 10th to 90th $1,072 to $2,138
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 $1,318.26 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,318.26 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,348.96 | $1,348.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,265.80 | Facility | None | $2,454.71 | $2,454.71 | $4,265.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,412.54 | $2,137.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $3,235.94 | Professional | None | $758.58 | $1,174.90 | $3,235.94 |
Health Alliance Plan Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $4,897.79 | Facility | None | $851.14 | $2,818.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,288.25 | $1,621.81 |
Priority Health Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,445.44 | Professional | None | $758.58 | $1,174.90 | $1,445.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,348.96 | $1,698.24 |
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 $575.44 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $199.53 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
Where Michigan sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 30th of 51
$1,380
AK $4,074UT $692
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.