How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,148 to $6,761Professionalmedian $1,698 · 10th to 90th $447 to $1,862
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 $1,737.80 Median $4,073.80 Typical High $6,918.31 | Facility | None | $1,737.80 | $4,073.80 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,778.28 | $1,778.28 |
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 $316.23 Median $1,737.80 Typical High $1,862.09 | Professional | None | $316.23 | $1,737.80 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,584.89 | $2,818.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $3,715.35 Typical High $4,897.79 | Facility | None | $1,778.28 | $3,715.35 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,778.28 | $1,995.26 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,479.11 | $2,290.87 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $9,120.11 | Facility | None | $851.14 | $2,238.72 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,548.82 | $1,737.80 |
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 $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,288.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,230.27 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $1,230.27 |
Where Michigan sits
The same service costs 11.0 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· 27th of 51
$1,738
AK $5,370TX $490
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.