How much rates vary
Facilitymedian $5,248 · 10th to 90th $955 to $8,318Professionalmedian $1,862 · 10th to 90th $1,413 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 $1,819.70 Median $1,862.09 Typical High $6,918.31 | Facility | None | $1,819.70 | $1,862.09 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,862.09 | $1,862.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $9,120.11 | Facility | None | $5,248.07 | $5,248.07 | $9,120.11 |
BCBS Michigan Setting Professional Modifier None Typical Low $380.19 Median $2,754.23 Typical High $2,884.03 | Professional | None | $380.19 | $2,754.23 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,365.16 | Professional | None | $1,023.29 | $1,621.81 | $4,365.16 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $4,073.80 Typical High $4,897.79 | Facility | None | $1,778.28 | $4,073.80 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,778.28 | $2,187.76 |
Priority Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,621.81 | $1,995.26 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,513.56 Typical High $6,456.54 | Facility | None | $645.65 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,862.09 | $2,344.23 |
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 $794.33 Median $912.01 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,202.26 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,288.25 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Michigan sits
The same service costs 5.8 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· 31st of 51
$1,862
AK $5,623UT $977
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.