How much rates vary
Facilitymedian $195 · 10th to 90th $117 to $2,455Professionalmedian $200 · 10th to 90th $155 to $302
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 $194.98 Median $213.80 Typical High $4,897.79 | Facility | None | $194.98 | $213.80 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | None | $194.98 | $204.17 | $213.80 |
BCBS Michigan Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $204.17 | Facility | None | $117.49 | $117.49 | $204.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $38.02 Median $263.03 Typical High $302.00 | Professional | None | $38.02 | $263.03 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
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 $107.15 Median $162.18 Typical High $436.52 | Professional | None | $107.15 | $162.18 | $436.52 |
Health Alliance Plan Setting Facility Modifier None Typical Low $114.82 Median $389.05 Typical High $4,897.79 | Facility | None | $114.82 | $389.05 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $213.80 | Professional | None | $154.88 | $199.53 | $213.80 |
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 $102.33 Median $125.89 Typical High $281.84 | Professional | None | $102.33 | $125.89 | $281.84 |
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 $154.88 Median $173.78 Typical High $208.93 | Professional | None | $154.88 | $173.78 | $208.93 |
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 $97.72 Median $102.33 Typical High $107.15 | Professional | 52 · Reduced service | $97.72 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | 53 · Discontinued | $38.90 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $151.36 Typical High $158.49 | Professional | 54 · Surgery only | $147.91 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $29.51 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.42 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.50 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $141.25 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $138.04 | $141.25 | $147.91 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $323.59 Typical High $398.11 | Professional | 50 · Both sides | $323.59 | $323.59 | $398.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $100.00 Typical High $107.15 | Professional | 52 · Reduced service | $95.50 | $100.00 | $107.15 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $39.81 Typical High $42.66 | Professional | 53 · Discontinued | $38.90 | $39.81 | $42.66 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $151.36 Typical High $158.49 | Professional | 54 · Surgery only | $144.54 | $151.36 | $158.49 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $31.62 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $31.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $21.38 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $141.25 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $134.90 | $141.25 | $147.91 |
Where Michigan sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$200
AK $603FL $132
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.