How much rates vary
Facilitymedian $240 · 10th to 90th $138 to $4,898Professionalmedian $589 · 10th to 90th $234 to $759
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 $741.31 Median $2,041.74 Typical High $4,897.79 | Facility | None | $741.31 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $794.33 | Professional | None | $741.31 | $758.58 | $794.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $257.04 | Facility | None | $138.04 | $138.04 | $257.04 |
BCBS Michigan Setting Professional Modifier None Typical Low $72.44 Median $380.19 Typical High $758.58 | Professional | None | $72.44 | $380.19 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,047.13 | Professional | None | $436.52 | $630.96 | $1,047.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $758.58 Median $1,698.24 Typical High $4,897.79 | Facility | None | $758.58 | $1,698.24 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $407.38 Median $741.31 Typical High $794.33 | Professional | None | $407.38 | $741.31 | $794.33 |
Priority Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $812.83 | Professional | None | $436.52 | $575.44 | $812.83 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,621.81 Typical High $8,709.64 | Facility | None | $645.65 | $1,621.81 | $8,709.64 |
United Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $407.38 | Professional | None | $302.00 | $354.81 | $407.38 |
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 $371.54 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $75.86 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 50 · Both sides | $812.83 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $549.54 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $75.86 |
Where Michigan sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 30th of 51
$589
AK $2,344HI $224
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.