How much rates vary
Facilitymedian $617 · 10th to 90th $347 to $1,549Professionalmedian $661 · 10th to 90th $490 to $741
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 $645.65 Median $831.76 Typical High $5,754.40 | Facility | None | $645.65 | $831.76 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $724.44 | Professional | None | $575.44 | $660.69 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $1,071.52 | Facility | None | $602.56 | $616.60 | $1,071.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $741.31 | Professional | None | $331.13 | $524.81 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
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 $354.81 Median $575.44 Typical High $1,174.90 | Professional | None | $354.81 | $575.44 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $338.84 Median $831.76 Typical High $5,754.40 | Facility | None | $338.84 | $831.76 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $724.44 | Professional | None | $524.81 | $660.69 | $724.44 |
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 $338.84 Median $478.63 Typical High $933.25 | Professional | None | $338.84 | $478.63 | $933.25 |
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 $575.44 Median $691.83 Typical High $812.83 | Professional | None | $575.44 | $691.83 | $812.83 |
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 $323.59 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $128.82 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $512.86 | Professional | 54 · Surgery only | $489.78 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $478.63 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $954.99 Typical High $954.99 | Professional | 50 · Both sides | $794.33 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $331.13 | $346.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $128.82 | $131.83 | $138.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $501.19 | $512.86 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $102.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $69.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $478.63 |
Where Michigan sits
The same service costs 6.2 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· 28th of 51
$661
AK $1,995UT $324
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.