How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,288 to $12,882Professionalmedian $1,622 · 10th to 90th $1,122 to $1,950
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 $1,621.81 Median $1,659.59 Typical High $6,918.31 | Facility | None | $1,621.81 | $1,659.59 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,621.81 | $1,698.24 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,943.28 Median $8,128.31 Typical High $13,803.84 | Facility | None | $7,943.28 | $8,128.31 | $13,803.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $309.03 Median $1,819.70 Typical High $2,570.40 | Professional | None | $309.03 | $1,819.70 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $4,265.80 | Professional | None | $954.99 | $1,479.11 | $4,265.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $5,011.87 | Facility | None | $3,235.94 | $4,897.79 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,621.81 | $1,819.70 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $2,238.72 | Professional | None | $954.99 | $1,380.38 | $2,238.72 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $891.25 | $2,818.38 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,513.56 | $1,659.59 |
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 $812.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,174.90 | $1,174.90 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | 50 · Both sides | $2,884.03 | $2,884.03 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $831.76 | $831.76 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $323.59 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,258.93 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $162.18 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,174.90 | $1,174.90 |
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· 26th of 51
$1,622
AK $5,129TX $676
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.