How much rates vary
Facilitymedian $1,202 · 10th to 90th $513 to $2,630Professionalmedian $417 · 10th to 90th $295 to $490
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 $407.38 Median $2,884.03 Typical High $4,897.79 | Facility | None | $407.38 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $457.09 | Professional | None | $331.13 | $436.52 | $457.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $2,089.30 | Facility | None | $1,202.26 | $1,230.27 | $2,089.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $467.74 | Professional | None | $79.43 | $446.68 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $1,023.29 | Professional | None | $257.04 | $363.08 | $1,023.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $416.87 Median $1,000.00 Typical High $4,897.79 | Facility | None | $416.87 | $1,000.00 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $501.19 | Professional | None | $346.74 | $416.87 | $501.19 |
Priority Health Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $524.81 | Professional | None | $257.04 | $363.08 | $524.81 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,951.21 | Facility | None | $426.58 | $602.56 | $2,951.21 |
United Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $537.03 | Professional | None | $380.19 | $426.58 | $537.03 |
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 $181.97 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $199.53 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $79.43 | $83.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $63.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $41.69 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $281.84 | $295.12 | $295.12 |
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· 33rd of 51
$437
AK $1,380UT $240
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.