How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,349 to $7,079Professionalmedian $1,514 · 10th to 90th $1,202 to $2,089
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 $1,412.54 Median $1,445.44 Typical High $6,918.31 | Facility | None | $1,412.54 | $1,445.44 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,445.44 | $1,513.56 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $6,606.93 | Facility | None | $3,715.35 | $3,801.89 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,548.82 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,412.54 Typical High $1,621.81 | Professional | None | $794.33 | $1,412.54 | $1,621.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $4,897.79 | Facility | None | $2,511.89 | $2,511.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,412.54 | $1,778.28 |
Priority Health Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,659.59 | Professional | None | $758.58 | $1,023.29 | $1,659.59 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,549.93 | Facility | None | $891.25 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,737.80 | $1,995.26 |
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 $575.44 Median $724.44 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $851.14 | $1,096.48 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $218.78 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,023.29 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $794.33 | $1,023.29 | $1,071.52 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 50 · Both sides | $2,290.87 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $269.15 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $977.24 |
Where Michigan sits
The same service costs 5.1 times more in Wisconsin 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· 36th of 51
$1,549
WI $4,677TX $912
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.