How much rates vary
Facilitymedian $3,311 · 10th to 90th $513 to $5,754Professionalmedian $1,148 · 10th to 90th $776 to $1,349
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 $1,122.02 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,122.02 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,174.90 | Professional | None | $912.01 | $1,174.90 | $1,174.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,311.31 Median $3,388.44 Typical High $5,754.40 | Facility | None | $3,311.31 | $3,388.44 | $5,754.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $218.78 Median $1,258.93 Typical High $1,258.93 | Professional | None | $218.78 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,754.23 | Professional | None | $707.95 | $1,000.00 | $2,754.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,148.15 Median $2,818.38 Typical High $6,918.31 | Facility | None | $1,148.15 | $2,818.38 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,412.54 | Professional | None | $954.99 | $1,148.15 | $1,412.54 |
Priority Health Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,445.44 | Professional | None | $707.95 | $1,000.00 | $1,445.44 |
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 $1,047.13 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,047.13 | $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 $501.19 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $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 $100.00 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $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 $549.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $794.33 |
Where Michigan sits
The same service costs 6.3 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· 29th of 51
$1,175
AK $3,715UT $589
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.