How much rates vary
Facilitymedian $1,096 · 10th to 90th $380 to $2,291Professionalmedian $309 · 10th to 90th $229 to $537
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 $316.23 Median $323.59 Typical High $4,897.79 | Facility | None | $316.23 | $323.59 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | None | $316.23 | $323.59 | $323.59 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,949.84 | Facility | None | $1,096.48 | $1,122.02 | $1,949.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $575.44 | Professional | None | $323.59 | $407.38 | $575.44 |
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 $186.21 Median $269.15 Typical High $446.68 | Professional | None | $186.21 | $269.15 | $446.68 |
Health Alliance Plan Setting Facility Modifier None Typical Low $288.40 Median $562.34 Typical High $4,897.79 | Facility | None | $288.40 | $562.34 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $323.59 | Professional | None | $229.09 | $302.00 | $323.59 |
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 $181.97 Median $263.03 Typical High $398.11 | Professional | None | $181.97 | $263.03 | $398.11 |
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 $239.88 Median $257.04 Typical High $302.00 | Professional | None | $239.88 | $257.04 | $302.00 |
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 $154.88 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $66.07 | Professional | 53 · Discontinued | $63.10 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $229.09 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 50 · Both sides | $616.60 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $158.49 Typical High $162.18 | Professional | 52 · Reduced service | $154.88 | $158.49 | $162.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $64.57 | Professional | 53 · Discontinued | $61.66 | $63.10 | $64.57 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $229.09 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $47.86 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $32.36 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $213.80 | $223.87 | $223.87 |
Where Michigan sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 26th of 51
$316
AK $1,023UT $191
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.