How much rates vary
Facilitymedian $1,514 · 10th to 90th $646 to $3,162Professionalmedian $457 · 10th to 90th $275 to $603
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 $380.19 Median $575.44 Typical High $4,897.79 | Facility | None | $380.19 | $575.44 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $602.56 | Professional | None | $380.19 | $398.11 | $602.56 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $2,691.53 | Facility | None | $1,513.56 | $1,548.82 | $2,691.53 |
BCBS Michigan Setting Professional Modifier None Typical Low $81.28 Median $407.38 Typical High $602.56 | Professional | None | $81.28 | $407.38 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $870.96 | Professional | None | $223.87 | $371.54 | $870.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $575.44 Median $1,548.82 Typical High $4,897.79 | Facility | None | $575.44 | $1,548.82 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $602.56 | Professional | None | $389.05 | $524.81 | $602.56 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $851.14 | Professional | None | $208.93 | $338.84 | $851.14 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $575.44 | Professional | None | $295.12 | $457.09 | $575.44 |
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 $190.55 Median $213.80 Typical High $295.12 | Professional | 52 · Reduced service | $190.55 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $120.23 | Professional | 53 · Discontinued | $75.86 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $446.68 | Professional | 54 · Surgery only | $288.40 | $316.23 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $89.13 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $416.87 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 50 · Both sides | $645.65 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $194.98 Typical High $302.00 | Professional | 52 · Reduced service | $186.21 | $194.98 | $302.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $77.62 Typical High $120.23 | Professional | 53 · Discontinued | $75.86 | $77.62 | $120.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $457.09 | Professional | 54 · Surgery only | $281.84 | $295.12 | $457.09 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $58.88 Typical High $91.20 | Professional | 55 · Aftercare only | $56.23 | $58.88 | $91.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.90 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.02 | $38.90 | $60.26 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $275.42 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $263.03 | $275.42 | $426.58 |
Where Michigan sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 34th of 51
$457
AK $1,585UT $288
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.