How much rates vary
Facilitymedian $251 · 10th to 90th $120 to $676Professionalmedian $117 · 10th to 90th $83 to $158
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 $102.33 Median $123.03 Typical High $4,897.79 | Facility | None | $102.33 | $123.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $131.83 | Professional | None | $102.33 | $109.65 | $131.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $436.52 | Facility | None | $251.19 | $257.04 | $436.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $16.60 Median $87.10 Typical High $123.03 | Professional | None | $16.60 | $87.10 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $213.80 | Professional | None | $63.10 | $107.15 | $213.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $104.71 Median $331.13 Typical High $4,897.79 | Facility | None | $104.71 | $331.13 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $162.18 | Professional | None | $104.71 | $128.82 | $162.18 |
Priority Health Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $173.78 | Professional | None | $61.66 | $89.13 | $173.78 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,258.93 | Facility | None | $91.20 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $151.36 | Professional | None | $95.50 | $117.49 | $151.36 |
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 $51.29 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $51.29 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $25.12 | Professional | 53 · Discontinued | $20.42 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $79.43 Typical High $95.50 | Professional | 54 · Surgery only | $75.86 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.85 Typical High $19.05 | Professional | 55 · Aftercare only | $15.49 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $74.13 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $70.79 | $74.13 | $89.13 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $173.78 Typical High $173.78 | Professional | 50 · Both sides | $131.83 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $50.12 | $52.48 | $63.10 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.89 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $20.89 | $25.70 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $77.62 Typical High $95.50 | Professional | 54 · Surgery only | $75.86 | $77.62 | $95.50 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $19.05 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $19.05 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $12.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $72.44 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $70.79 | $72.44 | $89.13 |
Where Michigan sits
The same service costs 4.2 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· 24th of 51
$123
AK $324FL $77.62
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.