How much rates vary
Facilitymedian $4,266 · 10th to 90th $912 to $7,244Professionalmedian $1,047 · 10th to 90th $813 to $1,738
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 $1,023.29 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,023.29 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,071.52 | $1,071.52 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,265.80 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $194.98 Median $1,659.59 Typical High $1,737.80 | Professional | None | $194.98 | $1,659.59 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $2,691.53 | Professional | None | $616.60 | $954.99 | $2,691.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $5,754.40 | Facility | None | $1,819.70 | $2,137.96 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,148.15 | Professional | None | $812.83 | $1,023.29 | $1,148.15 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,412.54 | Professional | None | $616.60 | $933.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,047.13 | Professional | None | $831.76 | $954.99 | $1,047.13 |
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 $512.86 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $741.31 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 50 · Both sides | $1,862.09 | $1,862.09 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $741.31 |
Where Michigan sits
The same service costs 7.4 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
$1,047
AK $3,311TX $447
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.