How much rates vary
Facilitymedian $257 · 10th to 90th $120 to $794Professionalmedian $347 · 10th to 90th $240 to $447
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 $338.84 Median $389.05 Typical High $4,897.79 | Facility | None | $338.84 | $389.05 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $407.38 | Professional | None | $338.84 | $371.54 | $407.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $436.52 | Facility | None | $251.19 | $257.04 | $436.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $50.12 Median $407.38 Typical High $467.74 | Professional | None | $50.12 | $407.38 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $501.19 | Professional | None | $204.17 | $302.00 | $501.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $562.34 Typical High $4,897.79 | Facility | None | $85.11 | $562.34 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $407.38 | Professional | None | $269.15 | $354.81 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $426.58 | Professional | None | $199.53 | $288.40 | $426.58 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $354.81 | Professional | None | $257.04 | $295.12 | $354.81 |
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 $169.82 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $239.88 | $245.47 | $275.42 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $512.86 Typical High $616.60 | Professional | 50 · Both sides | $501.19 | $512.86 | $616.60 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $173.78 | $194.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $69.18 | $77.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $251.19 | $263.03 | $288.40 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $52.48 | $57.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $34.67 | $38.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $234.42 | $245.47 | $269.15 |
Where Michigan sits
The same service costs 5.4 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· 25th of 51
$339
AK $1,096TX $204
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.