How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,202 to $4,898Professionalmedian $1,349 · 10th to 90th $1,000 to $2,138
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 $1,412.54 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,412.54 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,445.44 | $1,445.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,890.45 | Facility | None | $2,238.72 | $2,238.72 | $3,890.45 |
BCBS Michigan Setting Professional Modifier None Typical Low $288.40 Median $1,548.82 Typical High $2,137.96 | Professional | None | $288.40 | $1,548.82 | $2,137.96 |
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 $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $2,137.96 | Professional | None | $776.25 | $1,096.48 | $2,137.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $4,897.79 | Facility | None | $1,318.26 | $2,630.27 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,288.25 | $1,445.44 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,995.26 | Professional | None | $758.58 | $954.99 | $1,995.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $6,918.31 | Facility | None | $851.14 | $2,238.72 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,202.26 | $1,445.44 |
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 $707.95 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $707.95 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,023.29 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 50 · Both sides | $2,290.87 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $707.95 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,023.29 |
Where Michigan sits
The same service costs 7.6 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
$1,413
AK $4,365UT $575
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.