How much rates vary
Facilitymedian $8,128 · 10th to 90th $501 to $12,589Professionalmedian $2,884 · 10th to 90th $2,089 to $6,918
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 $2,884.03 Median $2,951.21 Typical High $6,918.31 | Facility | None | $2,884.03 | $2,951.21 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,238.72 | $3,090.30 | $3,090.30 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $14,125.38 | Facility | None | $8,128.31 | $8,128.31 | $14,125.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $3,019.95 Median $4,677.35 Typical High $6,918.31 | Professional | None | $3,019.95 | $4,677.35 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $7,762.47 | Professional | None | $1,778.28 | $2,344.23 | $7,762.47 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,818.38 Median $5,623.41 Typical High $6,165.95 | Facility | None | $2,818.38 | $5,623.41 | $6,165.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $3,548.13 | Professional | None | $2,089.30 | $2,754.23 | $3,548.13 |
Priority Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,951.21 | $3,801.89 |
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 $2,238.72 Median $2,570.40 Typical High $3,467.37 | Professional | None | $2,238.72 | $2,570.40 | $3,467.37 |
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 $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,122.02 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $446.68 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,659.59 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $331.13 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $223.87 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,137.96 | $2,137.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,412.54 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $562.34 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,089.30 | $2,187.76 | $2,187.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $281.84 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,041.74 | $2,041.74 |
Where Michigan sits
The same service costs 8.1 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
$2,951
AK $8,913TX $1,096
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.