How much rates vary
Facilitymedian $2,291 · 10th to 90th $912 to $4,677Professionalmedian $1,318 · 10th to 90th $977 to $2,089
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 $1,258.93 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,258.93 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,288.25 | $1,288.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,981.07 | Facility | None | $2,290.87 | $2,290.87 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $239.88 Median $1,995.26 Typical High $2,089.30 | Professional | None | $239.88 | $1,995.26 | $2,089.30 |
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 $724.44 Median $1,230.27 Typical High $1,778.28 | Professional | None | $724.44 | $1,230.27 | $1,778.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,819.70 | $2,754.23 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,318.26 | $1,479.11 |
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 $724.44 Median $1,122.02 Typical High $1,621.81 | Professional | None | $724.44 | $1,122.02 | $1,621.81 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,380.38 | Professional | None | $977.24 | $1,174.90 | $1,380.38 |
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 $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $251.19 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 50 · Both sides | $2,238.72 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $933.25 |
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· 28th of 51
$1,318
AK $3,981TX $525
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.