How much rates vary
Facilitymedian $6,761 · 10th to 90th $617 to $15,488Professionalmedian $479 · 10th to 90th $219 to $1,738
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 $323.59 Median $1,584.89 Typical High $4,897.79 | Facility | None | $323.59 | $1,584.89 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $1,096.48 Typical High $1,621.81 | Professional | None | $229.09 | $1,096.48 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,165.95 Median $8,317.64 Typical High $19,054.61 | Facility | None | $6,165.95 | $8,317.64 | $19,054.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $64.57 Median $338.84 Typical High $478.63 | Professional | None | $64.57 | $338.84 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $758.58 Typical High $2,290.87 | Professional | None | $239.88 | $758.58 | $2,290.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $338.84 Median $2,818.38 Typical High $4,897.79 | Facility | None | $338.84 | $2,818.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $269.15 Median $1,288.25 Typical High $1,698.24 | Professional | None | $269.15 | $1,288.25 | $1,698.24 |
Priority Health Setting Professional Modifier None Typical Low $239.88 Median $851.14 Typical High $1,905.46 | Professional | None | $239.88 | $851.14 | $1,905.46 |
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 $295.12 Median $1,000.00 Typical High $1,949.84 | Professional | None | $295.12 | $1,000.00 | $1,949.84 |
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 $162.18 Median $575.44 Typical High $812.83 | Professional | 52 · Reduced service | $162.18 | $575.44 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $234.42 Typical High $323.59 | Professional | 53 · Discontinued | $64.57 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $870.96 Typical High $1,202.26 | Professional | 54 · Surgery only | $245.47 | $870.96 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $173.78 Typical High $239.88 | Professional | 55 · Aftercare only | $48.98 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $117.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $32.36 | $117.49 | $162.18 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $512.86 Typical High $2,951.21 | Professional | 50 · Both sides | $512.86 | $512.86 | $2,951.21 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $489.78 Typical High $812.83 | Professional | 52 · Reduced service | $154.88 | $489.78 | $812.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $194.98 Typical High $331.13 | Professional | 53 · Discontinued | $61.66 | $194.98 | $331.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $724.44 Typical High $1,230.27 | Professional | 54 · Surgery only | $234.42 | $724.44 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $147.91 Typical High $245.47 | Professional | 55 · Aftercare only | $46.77 | $147.91 | $245.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $97.72 Typical High $165.96 | Professional | 56 · Pre-op care only | $30.90 | $97.72 | $165.96 |
Where Michigan sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 47th of 51
$479
WA $1,820HI $316
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.