How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,000 to $5,754Professionalmedian $1,622 · 10th to 90th $1,175 to $2,818
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 $1,778.28 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,778.28 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,778.28 | $1,819.70 | $1,819.70 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,019.95 Median $3,090.30 Typical High $5,248.07 | Facility | None | $3,019.95 | $3,090.30 | $5,248.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,995.26 | $2,818.38 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,754.23 | Professional | None | $954.99 | $1,318.26 | $2,754.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $5,754.40 | Facility | None | $2,290.87 | $3,090.30 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,548.82 | $1,862.09 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $4,073.80 | Professional | None | $954.99 | $1,288.25 | $4,073.80 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,760.83 | Facility | None | $660.69 | $1,548.82 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,412.54 | $1,737.80 |
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 $891.25 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $891.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,318.26 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,288.25 | $1,288.25 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 50 · Both sides | $3,019.95 | $3,019.95 | $3,019.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $891.25 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $354.81 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,348.96 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $269.15 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $177.83 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,288.25 | $1,288.25 |
Where Michigan sits
The same service costs 7.4 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· 25th of 51
$1,778
AK $5,623UT $759
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.