How much rates vary
Facilitymedian $2,512 · 10th to 90th $891 to $5,129Professionalmedian $851 · 10th to 90th $589 to $1,380
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 $851.14 Median $891.25 Typical High $6,918.31 | Facility | None | $851.14 | $891.25 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $933.25 | Professional | None | $851.14 | $891.25 | $933.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $4,365.16 | Facility | None | $2,511.89 | $2,511.89 | $4,365.16 |
BCBS Michigan Setting Professional Modifier None Typical Low $165.96 Median $1,047.13 Typical High $1,445.44 | Professional | None | $165.96 | $1,047.13 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $2,238.72 | Professional | None | $512.86 | $794.33 | $2,238.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $4,897.79 | Facility | None | $891.25 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $954.99 | Professional | None | $676.08 | $870.96 | $954.99 |
Priority Health Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,174.90 | Professional | None | $512.86 | $776.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $870.96 | Professional | None | $691.83 | $794.33 | $870.96 |
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 $426.58 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $616.60 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 50 · Both sides | $1,548.82 | $1,548.82 | $1,548.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $616.60 |
Where Michigan sits
The same service costs 8.1 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· 29th of 51
$851
AK $2,754TX $339
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.