How much rates vary
Facilitymedian $2,399 · 10th to 90th $813 to $4,898Professionalmedian $871 · 10th to 90th $646 to $1,230
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 $812.83 Median $4,073.80 Typical High $5,754.40 | Facility | None | $812.83 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $870.96 | Professional | None | $645.65 | $831.76 | $870.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $4,168.69 | Facility | None | $2,398.83 | $2,398.83 | $4,168.69 |
BCBS Michigan Setting Professional Modifier None Typical Low $165.96 Median $891.25 Typical High $1,230.27 | Professional | None | $165.96 | $891.25 | $1,230.27 |
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 $457.09 Median $741.31 Typical High $1,023.29 | Professional | None | $457.09 | $741.31 | $1,023.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,737.80 | $2,511.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,000.00 | Professional | None | $691.83 | $812.83 | $1,000.00 |
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 $426.58 Median $741.31 Typical High $1,513.56 | Professional | None | $426.58 | $741.31 | $1,513.56 |
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 $724.44 Median $954.99 Typical High $1,096.48 | Professional | None | $724.44 | $954.99 | $1,096.48 |
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 $323.59 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $489.78 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $97.72 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $457.09 | $575.44 | $602.56 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 50 · Both sides | $1,318.26 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $562.34 |
Where Michigan sits
The same service costs 5.9 times more in Alaska than in Texas. 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
$891
AK $3,236TX $550
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.