How much rates vary
Facilitymedian $1,514 · 10th to 90th $550 to $3,162Professionalmedian $1,585 · 10th to 90th $195 to $2,344
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 $208.93 Median $1,698.24 Typical High $4,897.79 | Facility | None | $208.93 | $1,698.24 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $1,380.38 Typical High $1,819.70 | Professional | None | $173.78 | $1,380.38 | $1,819.70 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,630.27 | Facility | None | $1,348.96 | $1,513.56 | $2,630.27 |
BCBS Michigan Setting Professional Modifier None Typical Low $40.74 Median $309.03 Typical High $2,187.76 | Professional | None | $40.74 | $309.03 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $2,238.72 | Professional | None | $158.49 | $269.15 | $2,238.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $870.96 Median $2,137.96 Typical High $4,677.35 | Facility | None | $870.96 | $2,137.96 | $4,677.35 |
Health Alliance Plan Setting Professional Modifier None Typical Low $204.17 Median $1,659.59 Typical High $2,187.76 | Professional | None | $204.17 | $1,659.59 | $2,187.76 |
Priority Health Setting Professional Modifier None Typical Low $117.49 Median $933.25 Typical High $2,187.76 | Professional | None | $117.49 | $933.25 | $2,187.76 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,311.31 | Facility | None | $426.58 | $602.56 | $3,311.31 |
United Setting Professional Modifier None Typical Low $194.98 Median $1,412.54 Typical High $2,691.53 | Professional | None | $194.98 | $1,412.54 | $2,691.53 |
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 $104.71 Median $691.83 Typical High $870.96 | Professional | 52 · Reduced service | $104.71 | $691.83 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $281.84 Typical High $346.74 | Professional | 53 · Discontinued | $42.66 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $1,047.13 Typical High $1,288.25 | Professional | 54 · Surgery only | $158.49 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $208.93 Typical High $263.03 | Professional | 55 · Aftercare only | $31.62 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $138.04 Typical High $173.78 | Professional | 56 · Pre-op care only | $20.89 | $138.04 | $173.78 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 50 · Both sides | $3,311.31 | $3,311.31 | $3,311.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $104.71 Typical High $933.25 | Professional | 52 · Reduced service | $102.33 | $104.71 | $933.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $371.54 | Professional | 53 · Discontinued | $40.74 | $42.66 | $371.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $1,380.38 | Professional | 54 · Surgery only | $151.36 | $158.49 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $281.84 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $281.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $186.21 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $186.21 |
Where Michigan sits
The same service costs 8.5 times more in Wisconsin 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· 17th of 51
$1,514
WI $2,291NE $269
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.