How much rates vary
Facilitymedian $5,495 · 10th to 90th $501 to $8,511Professionalmedian $1,905 · 10th to 90th $1,318 to $2,884
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 $1,905.46 Median $1,949.84 Typical High $6,918.31 | Facility | None | $1,905.46 | $1,949.84 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,905.46 | $1,949.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $9,549.93 | Facility | None | $5,495.41 | $5,495.41 | $9,549.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $338.84 Median $1,995.26 Typical High $3,019.95 | Professional | None | $338.84 | $1,995.26 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $4,570.88 | Professional | None | $1,071.52 | $1,698.24 | $4,570.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,862.09 Median $4,265.80 Typical High $4,897.79 | Facility | None | $1,862.09 | $4,265.80 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,862.09 | $2,290.87 |
Priority Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,698.24 | $2,089.30 |
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 $1,659.59 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,949.84 | $2,454.71 |
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 $831.76 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $331.13 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $190.55 Typical High $194.98 | Professional | 56 · Pre-op care only | $165.96 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
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· 29th of 51
$1,905
AK $5,888UT $1,000
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.