How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $9,333Professionalmedian $1,698 · 10th to 90th $1,148 to $1,995
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 $1,584.89 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,584.89 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,698.24 | $1,698.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,623.41 Median $5,754.40 Typical High $9,772.37 | Facility | None | $5,623.41 | $5,754.40 | $9,772.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $3,890.45 | Professional | None | $1,000.00 | $1,445.44 | $3,890.45 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $5,754.40 | Facility | None | $2,951.21 | $3,630.78 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,621.81 | $2,041.74 |
Priority Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,445.44 | $2,089.30 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,912.51 | Facility | None | $851.14 | $2,238.72 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,737.80 | $2,137.96 |
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 $724.44 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $724.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $288.40 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,096.48 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $316.23 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $158.49 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,148.15 |
Where Michigan sits
The same service costs 6.9 times more in Alaska than in Texas. 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
$1,698
AK $5,370TX $776
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.