How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,259 to $10,471Professionalmedian $1,413 · 10th to 90th $955 to $1,660
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 $1,348.96 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,348.96 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,445.44 | $1,445.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,025.60 Median $6,165.95 Typical High $10,715.19 | Facility | None | $6,025.60 | $6,165.95 | $10,715.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $302.00 Median $954.99 Typical High $1,513.56 | Professional | None | $302.00 | $954.99 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,513.56 Typical High $3,981.07 | Professional | None | $851.14 | $1,513.56 | $3,981.07 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,380.38 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,380.38 | $3,467.37 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,380.38 | $1,778.28 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $3,467.37 | Professional | None | $851.14 | $1,230.27 | $3,467.37 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $891.25 | $2,818.38 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,513.56 | $1,862.09 |
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 $616.60 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $676.08 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $269.15 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $134.90 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $977.24 |
Where Michigan sits
The same service costs 8.7 times more in Oklahoma 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· 36th of 51
$1,445
OK $6,166TX $708
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.