How much rates vary
Facilitymedian $355 · 10th to 90th $229 to $1,905Professionalmedian $398 · 10th to 90th $263 to $912
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 $354.81 Median $389.05 Typical High $5,754.40 | Facility | None | $354.81 | $389.05 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | None | $354.81 | $389.05 | $436.52 |
BCBS Michigan Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $407.38 | Facility | None | $229.09 | $234.42 | $407.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $74.13 Median $389.05 Typical High $549.54 | Professional | None | $74.13 | $389.05 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
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 $204.17 Median $537.03 Typical High $870.96 | Professional | None | $204.17 | $537.03 | $870.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $309.03 Median $758.58 Typical High $5,754.40 | Facility | None | $309.03 | $758.58 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $363.08 Median $602.56 Typical High $954.99 | Professional | None | $363.08 | $602.56 | $954.99 |
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 $194.98 Median $467.74 Typical High $741.31 | Professional | None | $194.98 | $467.74 | $741.31 |
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 $331.13 Median $676.08 Typical High $851.14 | Professional | None | $331.13 | $676.08 | $851.14 |
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 $177.83 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $177.83 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $70.79 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $53.70 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $35.48 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $257.04 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $251.19 | $257.04 | $275.42 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | 50 · Both sides | $588.84 | $588.84 | $741.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $177.83 | $181.97 | $199.53 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $70.79 | $72.44 | $79.43 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $295.12 | Professional | 54 · Surgery only | $263.03 | $275.42 | $295.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $58.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $39.81 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $39.81 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $257.04 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $245.47 | $257.04 | $275.42 |
Where Michigan sits
The same service costs 5.0 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· 35th of 51
$398
AK $1,096UT $219
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.