How much rates vary
Facilitymedian $8,710 · 10th to 90th $501 to $13,490Professionalmedian $3,162 · 10th to 90th $2,512 to $4,898
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 $3,090.30 Median $3,162.28 Typical High $6,918.31 | Facility | None | $3,090.30 | $3,162.28 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,454.71 | $3,311.31 | $3,311.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,709.64 Median $8,912.51 Typical High $15,135.61 | Facility | None | $8,709.64 | $8,912.51 | $15,135.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $5,248.07 | Professional | None | $1,995.26 | $4,897.79 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $8,511.38 | Professional | None | $1,905.46 | $2,884.03 | $8,511.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,019.95 Median $6,918.31 Typical High $7,413.10 | Facility | None | $3,019.95 | $6,918.31 | $7,413.10 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,511.89 | $3,162.28 | $4,168.69 |
Priority Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $4,073.80 | Professional | None | $1,905.46 | $3,162.28 | $4,073.80 |
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 $2,630.27 Median $2,884.03 Typical High $3,890.45 | Professional | None | $2,630.27 | $2,884.03 | $3,890.45 |
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 $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,230.27 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $489.78 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,819.70 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $363.08 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $245.47 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,513.56 | $1,584.89 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $602.56 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,290.87 | $2,344.23 | $2,344.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $457.09 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $302.00 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,187.76 | $2,187.76 |
Where Michigan sits
The same service costs 7.6 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
$3,162
AK $9,550TX $1,259
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.