How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,202 to $6,457Professionalmedian $2,188 · 10th to 90th $1,413 to $2,754
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 $2,187.76 Median $2,238.72 Typical High $6,918.31 | Facility | None | $2,187.76 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,698.24 | $2,290.87 | $2,290.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $6,165.95 | Facility | None | $3,548.13 | $3,548.13 | $6,165.95 |
BCBS Michigan Setting Professional Modifier None Typical Low $478.63 Median $2,187.76 Typical High $2,951.21 | Professional | None | $478.63 | $2,187.76 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,348.96 | $2,187.76 | $3,388.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $5,248.07 | Facility | None | $2,041.74 | $2,187.76 | $5,248.07 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,778.28 | $2,187.76 | $2,884.03 |
Priority Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,348.96 | $2,290.87 | $3,388.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,762.47 | Facility | None | $851.14 | $2,238.72 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,698.24 | $2,041.74 | $2,691.53 |
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 $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $851.14 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $338.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,258.93 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $251.19 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,621.81 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,071.52 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $426.58 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $213.80 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,548.82 |
Where Michigan sits
The same service costs 6.6 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· 30th of 51
$2,188
AK $6,607TX $1,000
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.