How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,047 to $5,129Professionalmedian $871 · 10th to 90th $692 to $1,318
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 $831.76 Median $870.96 Typical High $6,918.31 | Facility | None | $831.76 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | None | $831.76 | $870.96 | $870.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $4,265.80 | Facility | None | $2,454.71 | $2,511.89 | $4,265.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $186.21 Median $933.25 Typical High $1,380.38 | Professional | None | $186.21 | $933.25 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,174.90 | Professional | None | $501.19 | $776.25 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $4,897.79 | Facility | None | $1,778.28 | $1,778.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,000.00 | Professional | None | $707.95 | $870.96 | $1,000.00 |
Priority Health Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,023.29 | Professional | None | $501.19 | $776.25 | $1,023.29 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,120.11 | Facility | None | $891.25 | $2,818.38 | $9,120.11 |
United Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $891.25 | Professional | None | $707.95 | $812.83 | $891.25 |
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 $416.87 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $602.56 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 50 · Both sides | $1,479.11 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $630.96 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $602.56 |
Where Michigan sits
The same service costs 7.6 times more in Oklahoma than in Texas. 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.