How much rates vary
Facilitymedian $9,772 · 10th to 90th $501 to $15,136Professionalmedian $3,467 · 10th to 90th $2,818 to $5,495
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 $3,467.37 Median $3,548.13 Typical High $6,918.31 | Facility | None | $3,467.37 | $3,548.13 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,691.53 | $3,715.35 | $3,715.35 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $16,982.44 | Facility | None | $9,772.37 | $9,772.37 | $16,982.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $630.96 Median $3,715.35 Typical High $5,495.41 | Professional | None | $630.96 | $3,715.35 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,235.94 Typical High $9,332.54 | Professional | None | $2,137.96 | $3,235.94 | $9,332.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,388.44 Median $7,413.10 Typical High $8,317.64 | Facility | None | $3,388.44 | $7,413.10 | $8,317.64 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $4,677.35 | Professional | None | $2,818.38 | $3,467.37 | $4,677.35 |
Priority Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,548.13 Typical High $4,570.88 | Professional | None | $2,137.96 | $3,548.13 | $4,570.88 |
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 $2,951.21 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,951.21 | $3,235.94 | $4,365.16 |
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 $1,380.38 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,380.38 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $549.54 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,089.30 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $416.87 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $275.42 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,570.40 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,698.24 | $1,737.80 | $1,737.80 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,511.89 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $501.19 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $338.84 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,454.71 | $2,454.71 |
Where Michigan sits
The same service costs 17.0 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· 20th of 51
$3,548
AK $10,471TX $617
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.