How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,122 to $7,413Professionalmedian $1,202 · 10th to 90th $933 to $1,950
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 $1,148.15 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,148.15 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,148.15 | $1,202.26 | $1,202.26 |
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 $1,288.25 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,949.84 | $1,949.84 |
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 $691.83 Median $1,071.52 Typical High $1,584.89 | Professional | None | $691.83 | $1,071.52 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $5,754.40 | Facility | None | $2,290.87 | $2,454.71 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,318.26 | Professional | None | $933.25 | $1,148.15 | $1,318.26 |
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 $691.83 Median $1,071.52 Typical High $1,445.44 | Professional | None | $691.83 | $1,071.52 | $1,445.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,912.51 | Facility | None | $851.14 | $2,238.72 | $8,912.51 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,202.26 | Professional | None | $954.99 | $1,096.48 | $1,202.26 |
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 $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 50 · Both sides | $2,089.30 | $2,089.30 | $2,089.30 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
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
$1,202
AK $3,715TX $468
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.