How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,047 to $6,607Professionalmedian $1,023 · 10th to 90th $776 to $1,479
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 $933.25 Median $4,897.79 Typical High $6,918.31 | Facility | None | $933.25 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | None | $933.25 | $977.24 | $977.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $4,897.79 | Facility | None | $2,818.38 | $2,884.03 | $4,897.79 |
BCBS Michigan Setting Professional Modifier None Typical Low $204.17 Median $1,023.29 Typical High $1,548.82 | Professional | None | $204.17 | $1,023.29 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $1,348.96 | Professional | None | $562.34 | $870.96 | $1,348.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,238.72 Median $3,981.07 Typical High $5,754.40 | Facility | None | $2,238.72 | $3,981.07 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,202.26 | Professional | None | $891.25 | $1,047.13 | $1,202.26 |
Priority Health Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,023.29 | Professional | None | $562.34 | $724.44 | $1,023.29 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,148.15 | Professional | None | $776.25 | $1,023.29 | $1,148.15 |
13 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 $457.09 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 50 · Both sides | $1,659.59 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
Where Michigan sits
The same service costs 7.2 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· 28th of 51
$1,023
AK $2,884TX $398
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.