How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,000 to $5,754Professionalmedian $1,660 · 10th to 90th $1,202 to $2,754
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 $1,737.80 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,737.80 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,778.28 | $1,778.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $5,128.61 | Facility | None | $2,951.21 | $2,951.21 | $5,128.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $309.03 Median $1,949.84 Typical High $2,754.23 | Professional | None | $309.03 | $1,949.84 | $2,754.23 |
CareSource Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $933.25 Median $1,288.25 Typical High $3,890.45 | Professional | None | $933.25 | $1,288.25 | $3,890.45 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $5,754.40 | Facility | None | $2,290.87 | $3,162.28 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,548.82 | $1,819.70 |
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 $912.01 Median $1,230.27 Typical High $3,890.45 | Professional | None | $912.01 | $1,230.27 | $3,890.45 |
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 $1,230.27 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,380.38 | $1,698.24 |
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 $851.14 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,258.93 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | 50 · Both sides | $2,884.03 | $2,884.03 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $870.96 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $263.03 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $173.78 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,258.93 |
Where Michigan sits
The same service costs 7.1 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· 27th of 51
$1,738
AK $5,370UT $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.