How much rates vary
Facilitymedian $4,266 · 10th to 90th $832 to $7,079Professionalmedian $832 · 10th to 90th $631 to $1,380
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 $812.83 Median $870.96 Typical High $6,918.31 | Facility | None | $812.83 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | None | $812.83 | $831.76 | $831.76 |
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 $251.19 Median $977.24 Typical High $1,380.38 | Professional | None | $251.19 | $977.24 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,122.02 | Professional | None | $478.63 | $741.31 | $1,122.02 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $4,897.79 | Facility | None | $1,479.11 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $891.25 | Professional | None | $630.96 | $812.83 | $891.25 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $1,023.29 | Professional | None | $478.63 | $724.44 | $1,023.29 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,456.54 | Facility | None | $602.56 | $1,230.27 | $6,456.54 |
United Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $831.76 | Professional | None | $645.65 | $741.31 | $831.76 |
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 $407.38 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $407.38 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $588.84 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 50 · Both sides | $1,479.11 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $588.84 |
Where Michigan sits
The same service costs 8.3 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
$832
AK $2,570TX $309
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.