How much rates vary
Facilitymedian $6,607 · 10th to 90th $501 to $10,233Professionalmedian $2,455 · 10th to 90th $1,995 to $2,818
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 $2,454.71 Median $2,570.40 Typical High $6,918.31 | Facility | None | $2,454.71 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,454.71 | $2,630.27 | $2,630.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $11,481.54 | Facility | None | $6,606.93 | $6,606.93 | $11,481.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $537.03 Median $2,818.38 Typical High $2,818.38 | Professional | None | $537.03 | $2,818.38 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,801.89 | Professional | None | $1,513.56 | $2,187.76 | $3,801.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $5,888.44 | Facility | None | $2,398.83 | $5,370.32 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,454.71 | $2,818.38 |
Priority Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,187.76 | $2,818.38 |
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 $1,905.46 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,187.76 | $2,454.71 |
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 $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,230.27 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,862.09 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $245.47 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,862.09 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,202.26 | $1,258.93 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $489.78 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,819.70 | $1,905.46 | $1,905.46 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $363.08 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $239.88 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,778.28 | $1,778.28 |
Where Michigan sits
The same service costs 22.9 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· 18th of 51
$2,455
AK $7,586TX $331
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.