How much rates vary
Facilitymedian $1,230 · 10th to 90th $490 to $2,951Professionalmedian $468 · 10th to 90th $302 to $676
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 $398.11 Median $575.44 Typical High $4,897.79 | Facility | None | $398.11 | $575.44 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $575.44 | Professional | None | $275.42 | $398.11 | $575.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $2,137.96 | Facility | None | $1,230.27 | $1,258.93 | $2,137.96 |
BCBS Michigan Setting Professional Modifier None Typical Low $91.20 Median $489.78 Typical High $758.58 | Professional | None | $91.20 | $489.78 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $741.31 | Professional | None | $257.04 | $436.52 | $741.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $398.11 Median $954.99 Typical High $5,888.44 | Facility | None | $398.11 | $954.99 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $616.60 | Professional | None | $302.00 | $467.74 | $616.60 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $660.69 | Professional | None | $229.09 | $407.38 | $660.69 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $588.84 | Professional | None | $354.81 | $457.09 | $588.84 |
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 $199.53 Median $204.17 Typical High $288.40 | Professional | 52 · Reduced service | $199.53 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $114.82 | Professional | 53 · Discontinued | $79.43 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $426.58 | Professional | 54 · Surgery only | $295.12 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $85.11 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $57.54 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $398.11 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $724.44 Typical High $1,122.02 | Professional | 50 · Both sides | $724.44 | $724.44 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $204.17 Typical High $295.12 | Professional | 52 · Reduced service | $194.98 | $204.17 | $295.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $117.49 | Professional | 53 · Discontinued | $77.62 | $81.28 | $117.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $446.68 | Professional | 54 · Surgery only | $295.12 | $309.03 | $446.68 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $89.13 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $89.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $58.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $416.87 |
Where Michigan sits
The same service costs 4.9 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· 32nd of 51
$468
AK $1,413UT $288
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.