How much rates vary
Facilitymedian $1,950 · 10th to 90th $813 to $4,074Professionalmedian $741 · 10th to 90th $170 to $1,202
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 $741.31 Median $977.24 Typical High $5,754.40 | Facility | None | $741.31 | $977.24 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | None | $741.31 | $776.25 | $776.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $144.54 Median $851.14 Typical High $1,288.25 | Professional | None | $144.54 | $851.14 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,445.44 | Professional | None | $446.68 | $691.83 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $1,479.11 Typical High $4,897.79 | Facility | None | $977.24 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $831.76 | Professional | None | $588.84 | $741.31 | $831.76 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,047.13 | Professional | None | $446.68 | $660.69 | $1,047.13 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $758.58 | Professional | None | $602.56 | $660.69 | $758.58 |
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 $371.54 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $371.54 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $562.34 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $549.54 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 50 · Both sides | $1,380.38 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $371.54 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $147.91 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $77.62 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $537.03 |
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· 27th of 51
$759
AK $2,399TX $295
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.