How much rates vary
Facilitymedian $1,549 · 10th to 90th $135 to $2,951Professionalmedian $1,259 · 10th to 90th $912 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 $1,258.93 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,258.93 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,318.26 | $1,318.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $2,754.23 | Facility | None | $1,548.82 | $1,584.89 | $2,754.23 |
BCBS Michigan Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $1,949.84 | Professional | None | $776.25 | $1,380.38 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $707.95 Median $1,000.00 Typical High $1,905.46 | Professional | None | $707.95 | $1,000.00 | $1,905.46 |
Health Alliance Plan Setting Facility Modifier None Typical Low $269.15 Median $2,398.83 Typical High $4,897.79 | Facility | None | $269.15 | $2,398.83 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,318.26 | Professional | None | $912.01 | $1,174.90 | $1,318.26 |
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 $676.08 Median $912.01 Typical High $1,778.28 | Professional | None | $676.08 | $912.01 | $1,778.28 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,513.56 | Facility | None | $91.20 | $177.83 | $1,513.56 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,288.25 | Professional | None | $977.24 | $1,096.48 | $1,288.25 |
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 $630.96 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $912.01 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 50 · Both sides | $2,089.30 | $2,089.30 | $2,089.30 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $912.01 |
Where Michigan sits
The same service costs 7.2 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· 23rd of 51
$1,259
AK $3,890UT $537
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.