How much rates vary
Facilitymedian $2,818 · 10th to 90th $87 to $6,310Professionalmedian $115 · 10th to 90th $48 to $457
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 $67.61 Median $323.59 Typical High $4,897.79 | Facility | None | $67.61 | $323.59 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $263.03 Typical High $346.74 | Professional | None | $46.77 | $263.03 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $7,762.47 | Facility | None | $2,511.89 | $3,388.44 | $7,762.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $37.15 Median $81.28 Typical High $114.82 | Professional | None | $37.15 | $81.28 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $169.82 Typical High $537.03 | Professional | None | $46.77 | $169.82 | $537.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $69.18 Median $416.87 Typical High $2,884.03 | Facility | None | $69.18 | $416.87 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $61.66 Median $338.84 Typical High $446.68 | Professional | None | $61.66 | $338.84 | $446.68 |
Priority Health Setting Professional Modifier None Typical Low $45.71 Median $190.55 Typical High $436.52 | Professional | None | $45.71 | $190.55 | $436.52 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,288.25 Typical High $2,089.30 | Facility | None | $302.00 | $1,288.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $60.26 Median $263.03 Typical High $501.19 | Professional | None | $60.26 | $263.03 | $501.19 |
12 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 $33.11 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $33.11 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $52.48 Typical High $66.07 | Professional | 53 · Discontinued | $13.18 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $194.98 Typical High $245.47 | Professional | 54 · Surgery only | $48.98 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $9.77 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $6.61 | $26.30 | $33.11 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 50 · Both sides | $338.84 | $338.84 | $338.84 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $123.03 Typical High $707.95 | Professional | 50 · Both sides | $123.03 | $123.03 | $707.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $31.62 | $117.49 | $169.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $44.67 Typical High $67.61 | Professional | 53 · Discontinued | $12.88 | $44.67 | $67.61 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $165.96 Typical High $251.19 | Professional | 54 · Surgery only | $47.86 | $165.96 | $251.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $33.11 Typical High $51.29 | Professional | 55 · Aftercare only | $9.55 | $33.11 | $51.29 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $22.39 Typical High $33.88 | Professional | 56 · Pre-op care only | $6.46 | $22.39 | $33.88 |
Where Michigan sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 49th of 51
$115
IA $417NE $85.11
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.