How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,259 to $6,918Professionalmedian $1,698 · 10th to 90th $1,259 to $2,630
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 $1,737.80 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,737.80 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,778.28 | $1,778.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $6,606.93 | Facility | None | $3,715.35 | $3,801.89 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $346.74 Median $1,862.09 Typical High $2,630.27 | Professional | None | $346.74 | $1,862.09 | $2,630.27 |
CareSource Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,265.80 | Professional | None | $3,890.45 | $3,890.45 | $4,265.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,754.40 | Facility | None | $2,137.96 | $3,311.31 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,659.59 | $1,778.28 |
Priority Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,570.40 Typical High $7,943.28 | Facility | None | $870.96 | $2,570.40 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,479.11 | $1,778.28 |
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 $870.96 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $870.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,258.93 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 50 · Both sides | $2,754.23 | $2,754.23 | $2,754.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,288.25 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,230.27 | $1,230.27 |
Where Michigan sits
The same service costs 8.3 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· 30th of 51
$1,738
WY $5,623UT $676
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.