How much rates vary
Facilitymedian $3,311 · 10th to 90th $501 to $5,248Professionalmedian $1,175 · 10th to 90th $794 to $1,862
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 $1,148.15 Median $1,174.90 Typical High $6,918.31 | Facility | None | $1,148.15 | $1,174.90 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,023.29 | $1,174.90 | $1,174.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $5,754.40 | Facility | None | $3,311.31 | $3,311.31 | $5,754.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $245.47 Median $1,230.27 Typical High $1,862.09 | Professional | None | $245.47 | $1,230.27 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $2,818.38 | Professional | None | $660.69 | $1,174.90 | $2,818.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,122.02 Median $2,630.27 Typical High $4,897.79 | Facility | None | $1,122.02 | $2,630.27 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,380.38 | Professional | None | $891.25 | $1,122.02 | $1,380.38 |
Priority Health Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,819.70 | Professional | None | $660.69 | $1,023.29 | $1,819.70 |
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 $1,023.29 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,202.26 | $1,479.11 |
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 $512.86 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $512.86 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $831.76 | $831.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Where Michigan sits
The same service costs 5.6 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· 28th of 51
$1,175
AK $3,548UT $631
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.