How much rates vary
Facilitymedian $224 · 10th to 90th $120 to $832Professionalmedian $417 · 10th to 90th $288 to $550
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 $416.87 Median $457.09 Typical High $4,897.79 | Facility | None | $416.87 | $457.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $501.19 | Professional | None | $354.81 | $436.52 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $346.74 | Facility | None | $199.53 | $204.17 | $346.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $66.07 Median $467.74 Typical High $588.84 | Professional | None | $66.07 | $467.74 | $588.84 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $446.68 | Professional | None | $316.23 | $331.13 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $616.60 | Professional | None | $251.19 | $363.08 | $616.60 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $436.52 Typical High $2,041.74 | Facility | None | $85.11 | $436.52 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $489.78 | Professional | None | $316.23 | $426.58 | $489.78 |
Priority Health Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $537.03 | Professional | None | $245.47 | $354.81 | $537.03 |
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 $281.84 Median $346.74 Typical High $416.87 | Professional | None | $281.84 | $346.74 | $416.87 |
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 $208.93 Median $218.78 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $85.11 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $316.23 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $295.12 | $309.03 | $316.23 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | 50 · Both sides | $630.96 | $630.96 | $707.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $208.93 | $213.80 | $223.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $83.18 | $87.10 | $91.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $309.03 | $323.59 | $338.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $67.61 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $44.67 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $44.67 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $316.23 |
Where Michigan sits
The same service costs 5.6 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· 24th of 51
$417
AK $1,380TX $245
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.