How much rates vary
Facilitymedian $1,413 · 10th to 90th $490 to $2,884Professionalmedian $479 · 10th to 90th $309 to $741
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 $489.78 Median $2,884.03 Typical High $4,897.79 | Facility | None | $489.78 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | None | $489.78 | $512.86 | $512.86 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,454.71 | Facility | None | $1,412.54 | $1,412.54 | $2,454.71 |
BCBS Michigan Setting Professional Modifier None Typical Low $85.11 Median $524.81 Typical High $741.31 | Professional | None | $85.11 | $524.81 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $741.31 | Professional | None | $275.42 | $398.11 | $741.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $4,897.79 | Facility | None | $512.86 | $1,071.52 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $512.86 | Professional | None | $363.08 | $467.74 | $512.86 |
Priority Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $691.83 | Professional | None | $263.03 | $309.03 | $691.83 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $501.19 | Professional | None | $389.05 | $426.58 | $501.19 |
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 $245.47 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $354.81 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 50 · Both sides | $794.33 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $371.54 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $75.86 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $354.81 |
Where Michigan sits
The same service costs 6.9 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· 26th of 51
$490
AK $1,514UT $219
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.