How much rates vary
Facilitymedian $1,479 · 10th to 90th $631 to $3,715Professionalmedian $447 · 10th to 90th $288 to $646
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 $407.38 Median $616.60 Typical High $5,754.40 | Facility | None | $407.38 | $616.60 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $630.96 | Professional | None | $407.38 | $426.58 | $630.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,570.40 | Facility | None | $1,479.11 | $1,479.11 | $2,570.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $85.11 Median $457.09 Typical High $794.33 | Professional | None | $85.11 | $457.09 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $954.99 | Professional | None | $239.88 | $398.11 | $954.99 |
Health Alliance Plan Setting Facility Modifier None Typical Low $616.60 Median $1,122.02 Typical High $4,897.79 | Facility | None | $616.60 | $1,122.02 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $630.96 | Professional | None | $371.54 | $489.78 | $630.96 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $933.25 | Professional | None | $223.87 | $354.81 | $933.25 |
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 $288.40 Median $398.11 Typical High $575.44 | Professional | None | $288.40 | $398.11 | $575.44 |
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 $204.17 Median $208.93 Typical High $309.03 | Professional | 52 · Reduced service | $204.17 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $125.89 | Professional | 53 · Discontinued | $81.28 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $467.74 | Professional | 54 · Surgery only | $302.00 | $316.23 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $93.33 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $41.69 Typical High $63.10 | Professional | 56 · Pre-op care only | $40.74 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $295.12 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $281.84 | $295.12 | $436.52 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,096.48 Typical High $1,174.90 | Professional | 50 · Both sides | $691.83 | $1,096.48 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $208.93 Typical High $316.23 | Professional | 52 · Reduced service | $199.53 | $208.93 | $316.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $125.89 | Professional | 53 · Discontinued | $79.43 | $83.18 | $125.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $302.00 | $309.03 | $478.63 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $95.50 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $95.50 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $63.10 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $63.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $281.84 | $288.40 | $446.68 |
Where Michigan sits
The same service costs 5.9 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· 36th of 51
$457
AK $1,698UT $288
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.