How much rates vary
Facilitymedian $1,622 · 10th to 90th $708 to $4,074Professionalmedian $513 · 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 $501.19 Median $4,073.80 Typical High $5,754.40 | Facility | None | $501.19 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | None | $501.19 | $524.81 | $524.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,621.81 | $1,659.59 | $2,884.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $891.25 | Professional | None | $371.54 | $645.65 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $1,174.90 | Professional | None | $295.12 | $478.63 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $1,479.11 Typical High $4,897.79 | Facility | None | $977.24 | $1,479.11 | $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 $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $724.44 | Professional | None | $295.12 | $467.74 | $724.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,456.54 | Facility | None | $602.56 | $1,230.27 | $6,456.54 |
United Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $524.81 | Professional | None | $398.11 | $436.52 | $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 $251.19 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $380.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $363.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 50 · Both sides | $954.99 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $100.00 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $371.54 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $77.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $363.08 |
Where Michigan sits
The same service costs 7.2 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· 29th of 51
$513
AK $1,622TX $224
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.