How much rates vary
Facilitymedian $9,333 · 10th to 90th $501 to $14,791Professionalmedian $3,311 · 10th to 90th $741 to $3,715
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 $3,388.44 Median $3,467.37 Typical High $6,918.31 | Facility | None | $3,388.44 | $3,467.37 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,630.27 | $3,548.13 | $3,548.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,332.54 Median $9,549.93 Typical High $16,595.87 | Facility | None | $9,332.54 | $9,549.93 | $16,595.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $630.96 Median $3,548.13 Typical High $3,715.35 | Professional | None | $630.96 | $3,548.13 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $9,120.11 | Professional | None | $2,089.30 | $3,090.30 | $9,120.11 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,311.31 Median $7,244.36 Typical High $8,128.31 | Facility | None | $3,311.31 | $7,244.36 | $8,128.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,754.23 Median $3,311.31 Typical High $4,168.69 | Professional | None | $2,754.23 | $3,311.31 | $4,168.69 |
Priority Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $4,365.16 | Professional | None | $2,089.30 | $3,467.37 | $4,365.16 |
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 $3,162.28 Typical High $4,168.69 | Professional | None | $2,630.27 | $3,162.28 | $4,168.69 |
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 $1,318.26 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,318.26 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $524.81 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,995.26 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $398.11 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $263.03 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,511.89 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,659.59 | $1,698.24 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $660.69 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,454.71 | $2,570.40 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $489.78 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $331.13 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,398.83 | $2,398.83 |
Where Michigan sits
The same service costs 10.0 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· 21st of 51
$3,388
AK $10,233TX $1,023
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.