How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $4,677Professionalmedian $912 · 10th to 90th $479 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 $537.03 Median $1,584.89 Typical High $5,754.40 | Facility | None | $537.03 | $1,584.89 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $1,202.26 Typical High $1,621.81 | Professional | None | $537.03 | $1,202.26 | $1,621.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,548.13 | Facility | None | $2,041.74 | $2,041.74 | $3,548.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $354.81 Median $758.58 Typical High $851.14 | Professional | None | $354.81 | $758.58 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $2,041.74 | Professional | None | $389.05 | $691.83 | $2,041.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,584.89 Median $3,467.37 Typical High $5,754.40 | Facility | None | $1,584.89 | $3,467.37 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $1,513.56 Typical High $1,862.09 | Professional | None | $537.03 | $1,513.56 | $1,862.09 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $302.00 Median $851.14 Typical High $1,698.24 | Professional | None | $302.00 | $851.14 | $1,698.24 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $467.74 Median $1,202.26 Typical High $1,949.84 | Professional | None | $467.74 | $1,202.26 | $1,949.84 |
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 $269.15 Median $630.96 Typical High $812.83 | Professional | 52 · Reduced service | $269.15 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $251.19 Typical High $323.59 | Professional | 53 · Discontinued | $107.15 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $933.25 Typical High $1,230.27 | Professional | 54 · Surgery only | $407.38 | $933.25 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $186.21 Typical High $245.47 | Professional | 55 · Aftercare only | $81.28 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $125.89 Typical High $162.18 | Professional | 56 · Pre-op care only | $53.70 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $870.96 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $380.19 | $870.96 | $1,148.15 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 50 · Both sides | $912.01 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $263.03 Typical High $831.76 | Professional | 52 · Reduced service | $257.04 | $263.03 | $831.76 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $331.13 | Professional | 53 · Discontinued | $102.33 | $107.15 | $331.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $1,230.27 | Professional | 54 · Surgery only | $380.19 | $398.11 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $245.47 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $245.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $165.96 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $165.96 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $371.54 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $354.81 | $371.54 | $1,148.15 |
Where Michigan sits
The same service costs 4.4 times more in Alaska 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· 37th of 51
$1,318
AK $3,020NE $692
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.