How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $4,365Professionalmedian $1,175 · 10th to 90th $417 to $1,950
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 $467.74 Median $1,862.09 Typical High $5,754.40 | Facility | None | $467.74 | $1,862.09 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $1,174.90 Typical High $1,905.46 | Professional | None | $467.74 | $1,174.90 | $1,905.46 |
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 $295.12 Median $741.31 Typical High $741.31 | Professional | None | $295.12 | $741.31 | $741.31 |
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 $331.13 Median $602.56 Typical High $2,398.83 | Professional | None | $331.13 | $602.56 | $2,398.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,412.54 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,412.54 | $2,884.03 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $457.09 Median $1,513.56 Typical High $1,949.84 | Professional | None | $457.09 | $1,513.56 | $1,949.84 |
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 $257.04 Median $1,000.00 Typical High $1,905.46 | Professional | None | $257.04 | $1,000.00 | $1,905.46 |
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 $407.38 Median $1,288.25 Typical High $1,949.84 | Professional | None | $407.38 | $1,288.25 | $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 $234.42 Median $588.84 Typical High $954.99 | Professional | 52 · Reduced service | $234.42 | $588.84 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $234.42 Typical High $380.19 | Professional | 53 · Discontinued | $93.33 | $234.42 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $891.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $346.74 | $891.25 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $177.83 Typical High $281.84 | Professional | 55 · Aftercare only | $69.18 | $177.83 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $117.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $46.77 | $117.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $831.76 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $323.59 | $831.76 | $1,318.26 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 50 · Both sides | $794.33 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $229.09 Typical High $977.24 | Professional | 52 · Reduced service | $223.87 | $229.09 | $977.24 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $389.05 | Professional | 53 · Discontinued | $89.13 | $91.20 | $389.05 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $1,445.44 | Professional | 54 · Surgery only | $331.13 | $346.74 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $288.40 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $288.40 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $194.98 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $194.98 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $1,348.96 |
Where Michigan sits
The same service costs 5.8 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· 40th of 51
$1,380
AK $3,548NE $617
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.