How much rates vary
Facilitymedian $1,047 · 10th to 90th $347 to $2,138Professionalmedian $275 · 10th to 90th $155 to $363
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 $223.87 Median $346.74 Typical High $4,897.79 | Facility | None | $223.87 | $346.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $346.74 | Professional | None | $223.87 | $257.04 | $346.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,819.70 | Facility | None | $1,047.13 | $1,047.13 | $1,819.70 |
BCBS Michigan Setting Professional Modifier None Typical Low $41.69 Median $245.47 Typical High $363.08 | Professional | None | $41.69 | $245.47 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $478.63 | Professional | None | $144.54 | $257.04 | $478.63 |
Health Alliance Plan Setting Facility Modifier None Typical Low $338.84 Median $676.08 Typical High $4,897.79 | Facility | None | $338.84 | $676.08 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $363.08 | Professional | None | $229.09 | $338.84 | $363.08 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $371.54 | Professional | None | $131.83 | $234.42 | $371.54 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,691.53 | Facility | None | $288.40 | $426.58 | $2,691.53 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $338.84 | Professional | None | $199.53 | $257.04 | $338.84 |
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 $112.20 Median $123.03 Typical High $173.78 | Professional | 52 · Reduced service | $112.20 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $48.98 Typical High $69.18 | Professional | 53 · Discontinued | $44.67 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $186.21 Typical High $257.04 | Professional | 54 · Surgery only | $165.96 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $33.11 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $24.55 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.39 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $173.78 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $154.88 | $173.78 | $239.88 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 50 · Both sides | $389.05 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $120.23 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $120.23 | $177.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $70.79 | Professional | 53 · Discontinued | $44.67 | $47.86 | $70.79 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $177.83 Typical High $269.15 | Professional | 54 · Surgery only | $165.96 | $177.83 | $269.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $53.70 | Professional | 55 · Aftercare only | $33.11 | $35.48 | $53.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $35.48 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $165.96 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $154.88 | $165.96 | $251.19 |
Where Michigan sits
The same service costs 4.1 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· 28th of 51
$288
AK $851TX $209
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.