How much rates vary
Facilitymedian $437 · 10th to 90th $295 to $3,090Professionalmedian $355 · 10th to 90th $186 to $479
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 $257.04 Median $407.38 Typical High $5,754.40 | Facility | None | $257.04 | $407.38 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $407.38 | Professional | None | $257.04 | $295.12 | $407.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $295.12 Median $302.00 Typical High $512.86 | Facility | None | $295.12 | $302.00 | $512.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $56.23 Median $275.42 Typical High $524.81 | Professional | None | $56.23 | $275.42 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
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 $158.49 Median $281.84 Typical High $707.95 | Professional | None | $158.49 | $281.84 | $707.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $302.00 Median $851.14 Typical High $4,897.79 | Facility | None | $302.00 | $851.14 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $457.09 | Professional | None | $263.03 | $398.11 | $457.09 |
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 $151.36 Median $229.09 Typical High $588.84 | Professional | None | $151.36 | $229.09 | $588.84 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $398.11 | Professional | None | $234.42 | $331.13 | $398.11 |
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 $128.82 Median $147.91 Typical High $204.17 | Professional | 52 · Reduced service | $128.82 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $51.29 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $223.87 Typical High $309.03 | Professional | 54 · Surgery only | $190.55 | $223.87 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $44.67 Typical High $61.66 | Professional | 55 · Aftercare only | $38.90 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.70 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $208.93 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $177.83 | $208.93 | $288.40 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 50 · Both sides | $776.25 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $144.54 Typical High $208.93 | Professional | 52 · Reduced service | $125.89 | $144.54 | $208.93 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $83.18 | Professional | 53 · Discontinued | $51.29 | $57.54 | $83.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $213.80 Typical High $316.23 | Professional | 54 · Surgery only | $190.55 | $213.80 | $316.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $63.10 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $63.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $41.69 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $295.12 |
Where Michigan sits
The same service costs 4.3 times more in Wyoming 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· 24th of 51
$355
WY $933UT $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.