How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $5,370Professionalmedian $1,380 · 10th to 90th $955 to $2,138
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 $1,380.38 Median $1,412.54 Typical High $6,918.31 | Facility | None | $1,380.38 | $1,412.54 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,412.54 | $1,445.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $5,888.44 | Facility | None | $3,388.44 | $3,388.44 | $5,888.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $295.12 Median $1,584.89 Typical High $2,238.72 | Professional | None | $295.12 | $1,584.89 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,621.81 | Professional | None | $758.58 | $1,202.26 | $1,621.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,318.26 Median $3,019.95 Typical High $4,897.79 | Facility | None | $1,318.26 | $3,019.95 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,318.26 | $1,584.89 |
Priority Health Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,621.81 | Professional | None | $724.44 | $977.24 | $1,621.81 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,445.44 | $1,737.80 |
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 $562.34 Median $707.95 Typical High $724.44 | Professional | 52 · Reduced service | $562.34 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $281.84 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $831.76 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $165.96 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $141.25 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $776.25 | $977.24 | $1,023.29 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 50 · Both sides | $2,398.83 | $2,398.83 | $2,398.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $660.69 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $954.99 |
Where Michigan sits
The same service costs 4.7 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· 23rd of 51
$1,445
AK $3,981TX $851
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.