How much rates vary
Facilitymedian $1,047 · 10th to 90th $550 to $2,570Professionalmedian $851 · 10th to 90th $692 to $1,380
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 $776.25 Median $4,073.80 Typical High $5,754.40 | Facility | None | $776.25 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $851.14 | Professional | None | $741.31 | $851.14 | $851.14 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,819.70 | Facility | None | $1,047.13 | $1,047.13 | $1,819.70 |
BCBS Michigan Setting Professional Modifier None Typical Low $186.21 Median $1,380.38 Typical High $1,380.38 | Professional | None | $186.21 | $1,380.38 | $1,380.38 |
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 $501.19 Median $776.25 Typical High $1,949.84 | Professional | None | $501.19 | $776.25 | $1,949.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $4,897.79 | Facility | None | $1,778.28 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,023.29 | Professional | None | $707.95 | $851.14 | $1,023.29 |
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 $501.19 Median $776.25 Typical High $977.24 | Professional | None | $501.19 | $776.25 | $977.24 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,096.48 | Professional | None | $741.31 | $831.76 | $1,096.48 |
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 $371.54 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $588.84 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,479.11 Typical High $1,862.09 | Professional | 50 · Both sides | $1,479.11 | $1,479.11 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $588.84 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $588.84 |
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· 32nd of 51
$851
AK $2,692UT $457
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.