How much rates vary
Facilitymedian $724 · 10th to 90th $513 to $4,898Professionalmedian $692 · 10th to 90th $437 to $1,072
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 $457.09 Median $676.08 Typical High $4,897.79 | Facility | None | $457.09 | $676.08 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $776.25 | Professional | None | $457.09 | $602.56 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $512.86 Median $524.81 Typical High $891.25 | Facility | None | $512.86 | $524.81 | $891.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $89.13 Median $660.69 Typical High $812.83 | Professional | None | $89.13 | $660.69 | $812.83 |
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 $309.03 Median $588.84 Typical High $891.25 | Professional | None | $309.03 | $588.84 | $891.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $501.19 Median $2,238.72 Typical High $6,606.93 | Facility | None | $501.19 | $2,238.72 | $6,606.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,096.48 | Professional | None | $457.09 | $707.95 | $1,096.48 |
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 $512.86 Typical High $891.25 | Professional | None | $257.04 | $512.86 | $891.25 |
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 $457.09 Median $831.76 Typical High $1,174.90 | Professional | None | $457.09 | $831.76 | $1,174.90 |
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 $229.09 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $229.09 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $93.33 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $524.81 | Professional | 54 · Surgery only | $346.74 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $323.59 | $380.19 | $489.78 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,230.27 Typical High $1,230.27 | Professional | 50 · Both sides | $741.31 | $1,230.27 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $251.19 Typical High $338.84 | Professional | 52 · Reduced service | $218.78 | $251.19 | $338.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $134.90 | Professional | 53 · Discontinued | $87.10 | $100.00 | $134.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $371.54 | $512.86 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $102.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $67.61 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $478.63 |
Where Michigan sits
The same service costs 4.3 times more in Wisconsin 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· 31st of 51
$692
WI $1,862TX $437
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.