How much rates vary
Facilitymedian $1,549 · 10th to 90th $437 to $3,020Professionalmedian $170 · 10th to 90th $110 to $234
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 $144.54 Median $229.09 Typical High $4,897.79 | Facility | None | $144.54 | $229.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $234.42 | Professional | None | $144.54 | $158.49 | $234.42 |
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 $93.33 Median $162.18 Typical High $295.12 | Professional | None | $93.33 | $162.18 | $295.12 |
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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $363.08 | Professional | None | $87.10 | $147.91 | $363.08 |
Health Alliance Plan Setting Facility Modifier None Typical Low $229.09 Median $933.25 Typical High $4,897.79 | Facility | None | $229.09 | $933.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $234.42 | Professional | None | $147.91 | $199.53 | $234.42 |
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 $85.11 Median $128.82 Typical High $331.13 | Professional | None | $85.11 | $128.82 | $331.13 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,311.31 | Facility | None | $426.58 | $602.56 | $3,311.31 |
United Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $213.80 | Professional | None | $112.20 | $165.96 | $213.80 |
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 $72.44 Median $79.43 Typical High $117.49 | Professional | 52 · Reduced service | $72.44 | $79.43 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $31.62 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $117.49 Typical High $173.78 | Professional | 54 · Surgery only | $107.15 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.85 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.45 | $15.85 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $109.65 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $100.00 | $109.65 | $162.18 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $239.88 Typical High $436.52 | Professional | 50 · Both sides | $239.88 | $239.88 | $436.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $74.13 Typical High $117.49 | Professional | 52 · Reduced service | $70.79 | $74.13 | $117.49 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $29.51 | $46.77 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $112.20 Typical High $177.83 | Professional | 54 · Surgery only | $107.15 | $112.20 | $177.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $35.48 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.79 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.13 | $14.79 | $23.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $104.71 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $100.00 | $104.71 | $165.96 |
Where Michigan sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 28th of 51
$186
AK $603KY $126
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.