How much rates vary
Facilitymedian $8,318 · 10th to 90th $501 to $12,882Professionalmedian $2,951 · 10th to 90th $2,239 to $4,677
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 $2,951.21 Median $3,019.95 Typical High $6,918.31 | Facility | None | $2,951.21 | $3,019.95 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,290.87 | $3,090.30 | $3,090.30 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,317.64 Median $8,511.38 Typical High $14,454.40 | Facility | None | $8,317.64 | $8,511.38 | $14,454.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $537.03 Median $3,162.28 Typical High $4,677.35 | Professional | None | $537.03 | $3,162.28 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $7,943.28 | Professional | None | $1,819.70 | $2,754.23 | $7,943.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,884.03 Median $6,456.54 Typical High $7,079.46 | Facility | None | $2,884.03 | $6,456.54 | $7,079.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,398.83 | $2,951.21 | $3,890.45 |
Priority Health Setting Professional Modifier None Typical Low $1,819.70 Median $3,019.95 Typical High $3,890.45 | Professional | None | $1,819.70 | $3,019.95 | $3,890.45 |
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 $2,511.89 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,511.89 | $2,754.23 | $3,715.35 |
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 $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,148.15 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $457.09 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,698.24 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $338.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $229.09 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,187.76 | $2,187.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,445.44 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $575.44 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,137.96 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $426.58 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $288.40 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,089.30 | $2,089.30 |
Where Michigan sits
The same service costs 13.5 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· 23rd of 51
$2,951
AK $8,913TX $661
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.