How much rates vary
Facilitymedian $1,047 · 10th to 90th $372 to $2,138Professionalmedian $525 · 10th to 90th $331 to $794
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 $467.74 Median $645.65 Typical High $6,918.31 | Facility | None | $467.74 | $645.65 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $645.65 | Professional | None | $323.59 | $467.74 | $645.65 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,819.70 | Facility | None | $1,047.13 | $1,071.52 | $1,819.70 |
BCBS Michigan Setting Professional Modifier None Typical Low $104.71 Median $562.34 Typical High $851.14 | Professional | None | $104.71 | $562.34 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $891.25 | Professional | None | $309.03 | $501.19 | $891.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $4,897.79 | Facility | None | $467.74 | $645.65 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $707.95 | Professional | None | $354.81 | $524.81 | $707.95 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $691.83 | Professional | None | $275.42 | $478.63 | $691.83 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,691.53 | Facility | None | $288.40 | $426.58 | $2,691.53 |
United Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $660.69 | Professional | None | $416.87 | $524.81 | $660.69 |
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 $229.09 Median $239.88 Typical High $323.59 | Professional | 52 · Reduced service | $229.09 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $128.82 | Professional | 53 · Discontinued | $93.33 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $489.78 | Professional | 54 · Surgery only | $346.74 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $97.72 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $64.57 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $457.09 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $851.14 Typical High $1,258.93 | Professional | 50 · Both sides | $851.14 | $851.14 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $239.88 Typical High $338.84 | Professional | 52 · Reduced service | $234.42 | $239.88 | $338.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $134.90 | Professional | 53 · Discontinued | $93.33 | $95.50 | $134.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $501.19 | Professional | 54 · Surgery only | $346.74 | $363.08 | $501.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $100.00 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $100.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $67.61 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $67.61 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $467.74 |
Where Michigan sits
The same service costs 4.8 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· 32nd of 51
$525
AK $1,549UT $324
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.