How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,202 to $10,000Professionalmedian $1,778 · 10th to 90th $331 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 $1,819.70 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,819.70 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,819.70 | Professional | None | $1,659.59 | $1,778.28 | $1,819.70 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,456.54 Median $6,606.93 Typical High $11,220.18 | Facility | None | $6,456.54 | $6,606.93 | $11,220.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $331.13 Median $1,148.15 Typical High $1,949.84 | Professional | None | $331.13 | $1,148.15 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $4,466.84 | Professional | None | $1,047.13 | $1,862.09 | $4,466.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,949.84 Median $3,801.89 Typical High $4,897.79 | Facility | None | $1,949.84 | $3,801.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,778.28 | $2,238.72 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,659.59 | $2,238.72 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,621.81 | $1,905.46 | $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 $870.96 Median $891.25 Typical High $912.01 | Professional | 52 · Reduced service | $870.96 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,318.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,258.93 | $1,258.93 |
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $269.15 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,258.93 |
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· 34th of 51
$1,778
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.