How much rates vary
Facilitymedian $2,291 · 10th to 90th $513 to $4,677Professionalmedian $692 · 10th to 90th $513 to $1,096
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 $549.54 Median $4,897.79 Typical High $6,918.31 | Facility | None | $549.54 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $588.84 | Professional | None | $478.63 | $575.44 | $588.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,290.87 Median $2,344.23 Typical High $3,981.07 | Facility | None | $2,290.87 | $2,344.23 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $1,096.48 | Professional | None | $524.81 | $588.84 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $616.60 Typical High $831.76 | Professional | None | $309.03 | $616.60 | $831.76 |
Health Alliance Plan Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $6,918.31 | Facility | None | $741.31 | $2,041.74 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $933.25 | Professional | None | $489.78 | $691.83 | $933.25 |
Priority Health Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $870.96 | Professional | None | $288.40 | $407.38 | $870.96 |
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 $512.86 Median $912.01 Typical High $1,071.52 | Professional | None | $512.86 | $912.01 | $1,071.52 |
11 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 $239.88 Median $288.40 Typical High $295.12 | Professional | 52 · Reduced service | $239.88 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $95.50 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $70.79 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $58.88 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 50 · Both sides | $1,174.90 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $389.05 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $53.70 |
Where Michigan sits
The same service costs 3.7 times more in Wisconsin than in New York. 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· 24th of 51
$741
WI $1,622NY $437
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.