How much rates vary
Facilitymedian $5,888 · 10th to 90th $933 to $9,333Professionalmedian $2,089 · 10th to 90th $1,380 to $3,311
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 $2,041.74 Median $4,073.80 Typical High $5,754.40 | Facility | None | $2,041.74 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $2,238.72 | Professional | None | $2,041.74 | $2,137.96 | $2,238.72 |
Ambetter Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $10,471.29 | Facility | None | $5,888.44 | $6,025.60 | $10,471.29 |
BCBS Michigan Setting Professional Modifier None Typical Low $380.19 Median $2,398.83 Typical High $3,311.31 | Professional | None | $380.19 | $2,398.83 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,905.46 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $7,244.36 | Facility | None | $4,073.80 | $4,897.79 | $7,244.36 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,659.59 | $2,137.96 | $2,344.23 |
Priority Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,621.81 | $2,187.76 |
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 $1,698.24 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,698.24 | $1,949.84 | $2,187.76 |
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 $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,023.29 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $407.38 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,513.56 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $309.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $1,479.11 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 50 · Both sides | $3,548.13 | $3,548.13 | $3,548.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,023.29 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $407.38 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,513.56 | $1,584.89 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $309.03 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $1,479.11 |
Where Michigan sits
The same service costs 6.3 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.
Physician feeFacility fee
AK $16,928TX $2,675
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.