How much rates vary
Facilitymedian $8,710 · 10th to 90th $501 to $13,490Professionalmedian $3,311 · 10th to 90th $2,239 to $5,623
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 $3,548.13 Typical High $6,918.31 | Facility | None | $3,388.44 | $3,548.13 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,630.27 | $3,630.78 | $3,630.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,709.64 Median $8,912.51 Typical High $15,488.17 | Facility | None | $8,709.64 | $8,912.51 | $15,488.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $2,238.72 Median $3,801.89 Typical High $5,623.41 | Professional | None | $2,238.72 | $3,801.89 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,951.21 Typical High $9,332.54 | Professional | None | $1,949.84 | $2,951.21 | $9,332.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,311.31 Median $5,623.41 Typical High $6,165.95 | Facility | None | $3,311.31 | $5,623.41 | $6,165.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $3,467.37 | Professional | None | $2,089.30 | $2,754.23 | $3,467.37 |
Priority Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $4,466.84 | Professional | None | $2,089.30 | $3,467.37 | $4,466.84 |
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 $2,344.23 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,344.23 | $2,570.40 | $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 $1,318.26 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,318.26 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $524.81 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,995.26 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $398.11 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $263.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,570.40 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,659.59 | $1,737.80 | $1,737.80 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $660.69 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,511.89 | $2,570.40 | $2,570.40 |
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 $331.13 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $331.13 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,398.83 | $2,398.83 |
Where Michigan sits
The same service costs 17.4 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· 19th of 51
$3,388
AK $10,471TX $603
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.