How much rates vary
Facilitymedian $1,950 · 10th to 90th $372 to $3,548Professionalmedian $525 · 10th to 90th $398 to $891
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 $524.81 Median $2,041.74 Typical High $4,897.79 | Facility | None | $524.81 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | None | $524.81 | $549.54 | $549.54 |
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 $117.49 Median $616.60 Typical High $933.25 | Professional | None | $117.49 | $616.60 | $933.25 |
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 $316.23 Median $467.74 Typical High $676.08 | Professional | None | $316.23 | $467.74 | $676.08 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $4,897.79 | Facility | None | $1,000.00 | $1,071.52 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $562.34 | Professional | None | $398.11 | $512.86 | $562.34 |
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 $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $3,388.44 | Facility | None | $288.40 | $426.58 | $3,388.44 |
United Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | None | $416.87 | $457.09 | $524.81 |
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 $263.03 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $389.05 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 50 · Both sides | $1,000.00 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $398.11 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $54.95 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $371.54 | $380.19 | $380.19 |
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
$525
AK $1,698TX $209
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.