How much rates vary
Facilitymedian $676 · 10th to 90th $437 to $1,698Professionalmedian $263 · 10th to 90th $129 to $372
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 $177.83 Median $346.74 Typical High $4,897.79 | Facility | None | $177.83 | $346.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $354.81 | Professional | None | $177.83 | $218.78 | $354.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $1,174.90 | Facility | None | $660.69 | $676.08 | $1,174.90 |
BCBS Michigan Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $446.68 | Professional | None | $114.82 | $194.98 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
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 $109.65 Median $245.47 Typical High $602.56 | Professional | None | $109.65 | $245.47 | $602.56 |
Health Alliance Plan Setting Facility Modifier None Typical Low $346.74 Median $660.69 Typical High $4,897.79 | Facility | None | $346.74 | $660.69 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $363.08 | Professional | None | $181.97 | $323.59 | $363.08 |
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 $107.15 Median $199.53 Typical High $501.19 | Professional | None | $107.15 | $199.53 | $501.19 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,951.21 | Facility | None | $426.58 | $602.56 | $2,951.21 |
United Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $338.84 | Professional | None | $141.25 | $263.03 | $338.84 |
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 $89.13 Median $114.82 Typical High $173.78 | Professional | 52 · Reduced service | $89.13 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $70.79 | Professional | 53 · Discontinued | $36.31 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $173.78 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $34.67 Typical High $52.48 | Professional | 55 · Aftercare only | $26.92 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.91 Typical High $35.48 | Professional | 56 · Pre-op care only | $17.78 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $162.18 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $125.89 | $162.18 | $245.47 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $295.12 Typical High $660.69 | Professional | 50 · Both sides | $295.12 | $295.12 | $660.69 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $102.33 Typical High $177.83 | Professional | 52 · Reduced service | $89.13 | $102.33 | $177.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $70.79 | Professional | 53 · Discontinued | $35.48 | $41.69 | $70.79 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $154.88 Typical High $269.15 | Professional | 54 · Surgery only | $131.83 | $154.88 | $269.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $53.70 | Professional | 55 · Aftercare only | $26.30 | $30.90 | $53.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $35.48 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $35.48 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $144.54 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $123.03 | $144.54 | $251.19 |
Where Michigan sits
The same service costs 4.7 times more in Alaska than in Virginia. 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
$275
AK $851VA $182
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.