How much rates vary
Facilitymedian $3,236 · 10th to 90th $891 to $6,166Professionalmedian $813 · 10th to 90th $575 to $912
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 $2,884.03 Typical High $4,897.79 | Facility | None | $831.76 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $870.96 | Professional | None | $691.83 | $851.14 | $870.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,623.41 | Facility | None | $3,235.94 | $3,311.31 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $181.97 Median $912.01 Typical High $912.01 | Professional | None | $181.97 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $2,344.23 | Professional | None | $489.78 | $812.83 | $2,344.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,548.82 Median $2,570.40 Typical High $4,897.79 | Facility | None | $1,548.82 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $954.99 | Professional | None | $616.60 | $812.83 | $954.99 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $2,089.30 | Professional | None | $489.78 | $724.44 | $2,089.30 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $977.24 | Professional | None | $630.96 | $724.44 | $977.24 |
12 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 $398.11 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $616.60 |
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 8.1 times more in Oklahoma 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· 31st of 51
$832
OK $3,548UT $437
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.