How much rates vary
Facilitymedian $1,778 · 10th to 90th $269 to $3,236Professionalmedian $214 · 10th to 90th $110 to $282
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 $199.53 Median $263.03 Typical High $4,897.79 | Facility | None | $199.53 | $263.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $275.42 | Professional | None | $186.21 | $218.78 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | None | $147.91 | $147.91 | $165.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,778.28 | $1,778.28 | $3,090.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $34.67 Median $173.78 Typical High $281.84 | Professional | None | $34.67 | $173.78 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $263.03 | Professional | None | $134.90 | $181.97 | $263.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $204.17 Median $1,071.52 Typical High $3,630.78 | Facility | None | $204.17 | $1,071.52 | $3,630.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $288.40 | Professional | None | $190.55 | $251.19 | $288.40 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $263.03 | Professional | None | $134.90 | $186.21 | $263.03 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $275.42 | Professional | None | $165.96 | $213.80 | $275.42 |
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 $97.72 Median $100.00 Typical High $131.83 | Professional | 52 · Reduced service | $97.72 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $39.81 Typical High $52.48 | Professional | 53 · Discontinued | $38.90 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | 54 · Surgery only | $147.91 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $39.81 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $186.21 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | 52 · Reduced service | $95.50 | $95.50 | $128.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $52.48 | Professional | 53 · Discontinued | $38.02 | $38.02 | $52.48 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | 54 · Surgery only | $144.54 | $144.54 | $194.98 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $38.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $25.70 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $181.97 |
Where Michigan sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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· 41st of 51
$214
AK $794KY $174
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.