How much rates vary
Facilitymedian $191 · 10th to 90th $120 to $871Professionalmedian $407 · 10th to 90th $302 to $646
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 $389.05 Median $512.86 Typical High $4,897.79 | Facility | None | $389.05 | $512.86 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $457.09 | Professional | None | $346.74 | $426.58 | $457.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $302.00 | Facility | None | $173.78 | $173.78 | $302.00 |
BCBS Michigan Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $724.44 | Professional | None | $302.00 | $512.86 | $724.44 |
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 $245.47 Median $354.81 Typical High $562.34 | Professional | None | $245.47 | $354.81 | $562.34 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $549.54 Typical High $2,884.03 | Facility | None | $85.11 | $549.54 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $457.09 | Professional | None | $323.59 | $416.87 | $457.09 |
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 $229.09 Median $338.84 Typical High $501.19 | Professional | None | $229.09 | $338.84 | $501.19 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $407.38 | Professional | None | $316.23 | $354.81 | $407.38 |
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 $194.98 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $77.62 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $295.12 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $281.84 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $275.42 | $281.84 | $309.03 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | 50 · Both sides | $776.25 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $199.53 | $218.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $77.62 | $81.28 | $87.10 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $302.00 | $323.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $64.57 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $43.65 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $302.00 |
Where Michigan sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 24th of 51
$407
AK $1,259UT $219
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.