How much rates vary
Facilitymedian $2,512 · 10th to 90th $794 to $4,898Professionalmedian $794 · 10th to 90th $550 to $1,259
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 $776.25 Median $4,073.80 Typical High $5,754.40 | Facility | None | $776.25 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | None | $776.25 | $794.33 | $794.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $4,365.16 | Facility | None | $2,511.89 | $2,570.40 | $4,365.16 |
BCBS Michigan Setting Professional Modifier None Typical Low $549.54 Median $954.99 Typical High $1,318.26 | Professional | None | $549.54 | $954.99 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,445.44 | Professional | None | $457.09 | $707.95 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,548.82 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $870.96 | Professional | None | $616.60 | $776.25 | $870.96 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,071.52 | Professional | None | $457.09 | $691.83 | $1,071.52 |
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 $630.96 Median $758.58 Typical High $851.14 | Professional | None | $630.96 | $758.58 | $851.14 |
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 $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $562.34 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 50 · Both sides | $1,412.54 | $1,412.54 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $154.88 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $562.34 |
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· 34th of 51
$794
AK $2,455TX $331
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.