How much rates vary
Facilitymedian $331 · 10th to 90th $234 to $1,023Professionalmedian $355 · 10th to 90th $234 to $490
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 $323.59 Median $398.11 Typical High $6,918.31 | Facility | None | $323.59 | $398.11 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $407.38 | Professional | None | $323.59 | $331.13 | $407.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $436.52 | Facility | None | $234.42 | $239.88 | $436.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $64.57 Median $346.74 Typical High $512.86 | Professional | None | $64.57 | $346.74 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $575.44 | Professional | None | $194.98 | $309.03 | $575.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $4,897.79 | Facility | None | $234.42 | $398.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $467.74 | Professional | None | $331.13 | $407.38 | $467.74 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $446.68 | Professional | None | $177.83 | $239.88 | $446.68 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $1,995.26 | Facility | None | $288.40 | $426.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $436.52 | Professional | None | $263.03 | $331.13 | $436.52 |
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 $162.18 Median $165.96 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $229.09 | $234.42 | $288.40 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $776.25 Typical High $776.25 | Professional | 50 · Both sides | $512.86 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $165.96 Typical High $204.17 | Professional | 52 · Reduced service | $158.49 | $165.96 | $204.17 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $66.07 | $81.28 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $309.03 | Professional | 54 · Surgery only | $239.88 | $251.19 | $309.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $61.66 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $61.66 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $33.11 | $40.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $234.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $223.87 | $234.42 | $288.40 |
Where Michigan sits
The same service costs 5.2 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· 30th of 51
$355
AK $1,000UT $191
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.