How much rates vary
Facilitymedian $977 · 10th to 90th $331 to $2,042Professionalmedian $282 · 10th to 90th $145 to $363
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 $275.42 Median $346.74 Typical High $4,897.79 | Facility | None | $275.42 | $346.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $338.84 | Professional | None | $239.88 | $281.84 | $338.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,698.24 | Facility | None | $977.24 | $977.24 | $1,698.24 |
BCBS Michigan Setting Professional Modifier None Typical Low $40.74 Median $151.36 Typical High $354.81 | Professional | None | $40.74 | $151.36 | $354.81 |
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 $177.83 Median $239.88 Typical High $338.84 | Professional | None | $177.83 | $239.88 | $338.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $302.00 Median $467.74 Typical High $2,041.74 | Facility | None | $302.00 | $467.74 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $371.54 | Professional | None | $263.03 | $331.13 | $371.54 |
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 $177.83 Median $239.88 Typical High $338.84 | Professional | None | $177.83 | $239.88 | $338.84 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,691.53 | Facility | None | $288.40 | $426.58 | $2,691.53 |
United Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $363.08 | Professional | None | $239.88 | $295.12 | $363.08 |
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 $134.90 Median $134.90 Typical High $165.96 | Professional | 52 · Reduced service | $134.90 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $54.95 Typical High $67.61 | Professional | 53 · Discontinued | $53.70 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $204.17 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.92 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $234.42 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $131.83 | $165.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $52.48 | $66.07 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $199.53 | $199.53 | $245.47 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $48.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $33.11 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $229.09 |
Where Michigan sits
The same service costs 3.9 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· 30th of 51
$295
AK $912KY $234
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.