How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,122 to $7,244Professionalmedian $2,344 · 10th to 90th $1,585 to $3,802
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 $4,897.79 Typical High $6,918.31 | Facility | None | $2,187.76 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,041.74 | $2,398.83 | $2,398.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $6,918.31 | Facility | None | $3,981.07 | $3,981.07 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $501.19 Median $2,691.53 Typical High $3,801.89 | Professional | None | $501.19 | $2,691.53 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $5,495.41 | Professional | None | $1,412.54 | $2,187.76 | $5,495.41 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $4,897.79 Typical High $5,754.40 | Facility | None | $2,570.40 | $4,897.79 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,949.84 | $2,398.83 | $2,818.38 |
Priority Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,412.54 | $2,187.76 | $2,691.53 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $3,090.30 | Professional | None | $2,041.74 | $2,290.87 | $3,090.30 |
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 $1,023.29 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,023.29 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $407.38 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,513.56 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,096.48 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $446.68 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,659.59 | $1,778.28 | $1,778.28 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $331.13 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $218.78 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,659.59 | $1,659.59 |
Where Michigan sits
The same service costs 6.9 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· 29th of 51
$2,399
AK $7,586TX $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.