How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $6,918Professionalmedian $1,479 · 10th to 90th $1,202 to $1,698
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 $1,445.44 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,479.11 | $1,479.11 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,073.80 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $933.25 Median $1,584.89 Typical High $1,698.24 | Professional | None | $933.25 | $1,584.89 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $2,454.71 | Professional | None | $851.14 | $1,348.96 | $2,454.71 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $4,897.79 | Facility | None | $2,041.74 | $2,884.03 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,479.11 | $1,698.24 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $1,949.84 | Professional | None | $851.14 | $1,318.26 | $1,949.84 |
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 $1,202.26 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,318.26 | $1,513.56 |
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 $724.44 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,047.13 |
Where Michigan sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 26th of 51
$1,479
AK $4,571UT $741
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.