How much rates vary
Facilitymedian $1,950 · 10th to 90th $794 to $4,169Professionalmedian $676 · 10th to 90th $490 to $813
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 $660.69 Median $870.96 Typical High $6,918.31 | Facility | None | $660.69 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | None | $602.56 | $707.95 | $707.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,995.26 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $131.83 Median $776.25 Typical High $776.25 | Professional | None | $131.83 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $1,698.24 | Professional | None | $416.87 | $602.56 | $1,698.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $645.65 Median $1,548.82 Typical High $6,918.31 | Facility | None | $645.65 | $1,548.82 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $812.83 | Professional | None | $524.81 | $676.08 | $812.83 |
Priority Health Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $851.14 | Professional | None | $416.87 | $602.56 | $851.14 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,025.60 | Facility | None | $660.69 | $1,548.82 | $6,025.60 |
United Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $870.96 | Professional | None | $588.84 | $707.95 | $870.96 |
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 $302.00 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $323.59 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $131.83 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $489.78 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $97.72 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $67.61 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $457.09 | $478.63 | $478.63 |
Where Michigan sits
The same service costs 6.0 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· 33rd of 51
$708
AK $2,239UT $372
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.