How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,047 to $5,754Professionalmedian $871 · 10th to 90th $646 to $1,122
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 $933.25 Median $4,897.79 Typical High $6,918.31 | Facility | None | $933.25 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | None | $933.25 | $954.99 | $954.99 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $4,677.35 | Facility | None | $2,691.53 | $2,691.53 | $4,677.35 |
BCBS Michigan Setting Professional Modifier None Typical Low $177.83 Median $1,047.13 Typical High $1,584.89 | Professional | None | $177.83 | $1,047.13 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,202.26 | Professional | None | $549.54 | $831.76 | $1,202.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,621.81 Median $2,238.72 Typical High $5,754.40 | Facility | None | $1,621.81 | $2,238.72 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $954.99 | Professional | None | $645.65 | $851.14 | $954.99 |
Priority Health Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,174.90 | Professional | None | $549.54 | $741.31 | $1,174.90 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,120.11 | Facility | None | $891.25 | $2,818.38 | $9,120.11 |
United Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $933.25 | Professional | None | $707.95 | $851.14 | $933.25 |
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 $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,659.59 Typical High $2,691.53 | Professional | 50 · Both sides | $1,659.59 | $1,659.59 | $2,691.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
Where Michigan sits
The same service costs 7.6 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· 30th of 51
$871
AK $2,951TX $389
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.