How much rates vary
Facilitymedian $5,495 · 10th to 90th $501 to $8,710Professionalmedian $1,950 · 10th to 90th $1,318 to $3,162
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 $1,949.84 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,949.84 | $1,995.26 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,513.56 | $2,041.74 | $2,041.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,495.41 Median $5,623.41 Typical High $9,549.93 | Facility | None | $5,495.41 | $5,623.41 | $9,549.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $416.87 Median $3,162.28 Typical High $4,786.30 | Professional | None | $416.87 | $3,162.28 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $5,248.07 | Professional | None | $1,202.26 | $1,819.70 | $5,248.07 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,905.46 Median $4,570.88 Typical High $4,897.79 | Facility | None | $1,905.46 | $4,570.88 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,949.84 | $2,570.40 |
Priority Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,949.84 | $2,570.40 |
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 $1,659.59 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,819.70 | $2,454.71 |
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 $758.58 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $758.58 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $302.00 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,122.02 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $223.87 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $151.36 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $933.25 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $380.19 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,412.54 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $281.84 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $190.55 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,380.38 | $1,380.38 |
Where Michigan sits
The same service costs 7.8 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· 21st of 51
$1,995
AK $5,888TX $759
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.