How much rates vary
Facilitymedian $479 · 10th to 90th $316 to $1,230Professionalmedian $372 · 10th to 90th $234 to $479
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 $302.00 Median $398.11 Typical High $4,897.79 | Facility | None | $302.00 | $398.11 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $416.87 | Professional | None | $288.40 | $331.13 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
BCBS Michigan Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $831.76 | Facility | None | $478.63 | $478.63 | $831.76 |
BCBS Michigan Setting Professional Modifier None Typical Low $194.98 Median $446.68 Typical High $489.78 | Professional | None | $194.98 | $446.68 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $186.21 Median $309.03 Typical High $691.83 | Professional | None | $186.21 | $309.03 | $691.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $309.03 Median $676.08 Typical High $2,041.74 | Facility | None | $309.03 | $676.08 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $416.87 | Professional | None | $302.00 | $363.08 | $416.87 |
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 $181.97 Median $245.47 Typical High $549.54 | Professional | None | $181.97 | $245.47 | $549.54 |
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 $281.84 Median $398.11 Typical High $478.63 | Professional | None | $281.84 | $398.11 | $478.63 |
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 $151.36 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $61.66 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $229.09 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $46.77 Typical High $58.88 | Professional | 55 · Aftercare only | $45.71 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $218.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $213.80 | $218.78 | $275.42 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $741.31 Typical High $741.31 | Professional | 50 · Both sides | $501.19 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $158.49 | $199.53 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $60.26 | $63.10 | $79.43 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $229.09 | $234.42 | $295.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $46.77 Typical High $60.26 | Professional | 55 · Aftercare only | $45.71 | $46.77 | $60.26 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $39.81 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $218.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $213.80 | $218.78 | $275.42 |
Where Michigan sits
The same service costs 4.2 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· 22nd of 51
$380
AK $955UT $229
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.