How much rates vary
Facilitymedian $1,660 · 10th to 90th $794 to $4,074Professionalmedian $724 · 10th to 90th $562 to $1,202
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 $724.44 Median $2,884.03 Typical High $4,897.79 | Facility | None | $724.44 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | None | $724.44 | $758.58 | $758.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,818.38 | Facility | None | $1,621.81 | $1,621.81 | $2,818.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $141.25 Median $831.76 Typical High $1,258.93 | Professional | None | $141.25 | $831.76 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,023.29 | Professional | None | $436.52 | $660.69 | $1,023.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,412.54 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $794.33 | Professional | None | $562.34 | $724.44 | $794.33 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $912.01 | Professional | None | $436.52 | $660.69 | $912.01 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $741.31 | Professional | None | $588.84 | $645.65 | $741.31 |
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 $363.08 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $524.81 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 50 · Both sides | $1,348.96 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $549.54 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $112.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $75.86 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $524.81 |
Where Michigan sits
The same service costs 7.9 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
$741
AK $2,344TX $295
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.