How much rates vary
Facilitymedian $525 · 10th to 90th $372 to $1,413Professionalmedian $468 · 10th to 90th $331 to $646
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 $457.09 Median $512.86 Typical High $4,897.79 | Facility | None | $457.09 | $512.86 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $549.54 | Professional | None | $426.58 | $501.19 | $549.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $912.01 | Facility | None | $524.81 | $524.81 | $912.01 |
BCBS Michigan Setting Professional Modifier None Typical Low $89.13 Median $501.19 Typical High $707.95 | Professional | None | $89.13 | $501.19 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $707.95 | Professional | None | $269.15 | $371.54 | $707.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $309.03 Median $954.99 Typical High $4,897.79 | Facility | None | $309.03 | $954.99 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $549.54 | Professional | None | $380.19 | $489.78 | $549.54 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $645.65 | Professional | None | $251.19 | $302.00 | $645.65 |
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 $354.81 Median $416.87 Typical High $512.86 | Professional | None | $354.81 | $416.87 | $512.86 |
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 $229.09 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $229.09 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $323.59 | $331.13 | $363.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $977.24 Typical High $977.24 | Professional | 50 · Both sides | $758.58 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $229.09 | $234.42 | $257.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $93.33 | $104.71 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $354.81 | $389.05 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $77.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $51.29 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $363.08 |
Where Michigan sits
The same service costs 5.6 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· 22nd of 51
$479
AK $1,413UT $251
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.