How much rates vary
Facilitymedian $490 · 10th to 90th $347 to $2,570Professionalmedian $372 · 10th to 90th $229 to $550
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 $316.23 Median $467.74 Typical High $4,897.79 | Facility | None | $316.23 | $467.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $467.74 | Professional | None | $223.87 | $323.59 | $467.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $346.74 Median $354.81 Typical High $616.60 | Facility | None | $346.74 | $354.81 | $616.60 |
BCBS Michigan Setting Professional Modifier None Typical Low $74.13 Median $398.11 Typical High $616.60 | Professional | None | $74.13 | $398.11 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $645.65 | Professional | None | $208.93 | $354.81 | $645.65 |
Health Alliance Plan Setting Facility Modifier None Typical Low $316.23 Median $467.74 Typical High $4,073.80 | Facility | None | $316.23 | $467.74 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $512.86 | Professional | None | $245.47 | $380.19 | $512.86 |
Priority Health Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $512.86 | Professional | None | $194.98 | $323.59 | $512.86 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $4,570.88 | Facility | None | $602.56 | $1,230.27 | $4,570.88 |
United Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $489.78 | Professional | None | $281.84 | $380.19 | $489.78 |
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 $158.49 Median $169.82 Typical High $234.42 | Professional | 52 · Reduced service | $158.49 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $69.18 Typical High $95.50 | Professional | 53 · Discontinued | $63.10 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $239.88 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $70.79 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $34.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $31.62 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $331.13 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $794.33 Typical High $933.25 | Professional | 50 · Both sides | $588.84 | $794.33 | $933.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $169.82 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $169.82 | $245.47 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $67.61 | $97.72 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $257.04 | $371.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $74.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $48.98 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $346.74 |
Where Michigan sits
The same service costs 4.3 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· 34th of 51
$372
AK $1,023TX $240
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.