How much rates vary
Facilitymedian $1,950 · 10th to 90th $646 to $4,074Professionalmedian $479 · 10th to 90th $347 to $617
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 $354.81 Median $512.86 Typical High $6,918.31 | Facility | None | $354.81 | $512.86 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $524.81 | Professional | None | $354.81 | $398.11 | $524.81 |
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 $257.04 Median $436.52 Typical High $616.60 | Professional | None | $257.04 | $436.52 | $616.60 |
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 $234.42 Median $416.87 Typical High $741.31 | Professional | None | $234.42 | $416.87 | $741.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $512.86 Median $1,348.96 Typical High $4,897.79 | Facility | None | $512.86 | $1,348.96 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $630.96 | Professional | None | $363.08 | $537.03 | $630.96 |
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 $213.80 Median $398.11 Typical High $660.69 | Professional | None | $213.80 | $398.11 | $660.69 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $588.84 | Professional | None | $323.59 | $446.68 | $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 $177.83 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $177.83 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $104.71 | Professional | 53 · Discontinued | $70.79 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $389.05 | Professional | 54 · Surgery only | $269.15 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $77.62 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $52.48 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $363.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 50 · Both sides | $660.69 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $186.21 Typical High $269.15 | Professional | 52 · Reduced service | $177.83 | $186.21 | $269.15 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $107.15 | Professional | 53 · Discontinued | $70.79 | $74.13 | $107.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $407.38 | Professional | 54 · Surgery only | $263.03 | $281.84 | $407.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $81.28 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $81.28 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $37.15 Typical High $53.70 | Professional | 56 · Pre-op care only | $35.48 | $37.15 | $53.70 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $245.47 | $263.03 | $380.19 |
Where Michigan sits
The same service costs 5.9 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· 21st of 51
$501
AK $1,413UT $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.