How much rates vary
Facilitymedian $1,514 · 10th to 90th $813 to $3,236Professionalmedian $692 · 10th to 90th $155 to $1,096
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 $870.96 Typical High $6,918.31 | Facility | None | $741.31 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | None | $741.31 | $776.25 | $776.25 |
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 $154.88 Median $776.25 Typical High $1,148.15 | Professional | None | $154.88 | $776.25 | $1,148.15 |
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 $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $1,148.15 | Professional | None | $407.38 | $645.65 | $1,148.15 |
Health Alliance Plan Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $4,897.79 | Facility | None | $933.25 | $933.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $758.58 | Professional | None | $524.81 | $691.83 | $758.58 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,047.13 | Professional | None | $398.11 | $537.03 | $1,047.13 |
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 $549.54 Median $630.96 Typical High $741.31 | Professional | None | $549.54 | $630.96 | $741.31 |
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 $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 $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $147.91 | $154.88 | $154.88 |
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 $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $537.03 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 50 · Both sides | $1,230.27 | $1,230.27 | $1,230.27 |
Health Alliance Plan 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 |
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 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $537.03 |
Where Michigan sits
The same service costs 8.5 times more in Wyoming 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· 29th of 51
$741
WY $2,512UT $295
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.