How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,047 to $6,457Professionalmedian $1,023 · 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 $1,047.13 Median $1,122.02 Typical High $6,918.31 | Facility | None | $1,047.13 | $1,122.02 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,096.48 | $1,122.02 |
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 $194.98 Median $1,148.15 Typical High $1,659.59 | Professional | None | $194.98 | $1,148.15 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $2,630.27 | Professional | None | $616.60 | $1,047.13 | $2,630.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $4,897.79 | Facility | None | $1,995.26 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,230.27 | Professional | None | $794.33 | $1,047.13 | $1,230.27 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $2,570.40 | Professional | None | $616.60 | $912.01 | $2,570.40 |
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 $812.83 Median $933.25 Typical High $1,258.93 | Professional | None | $812.83 | $933.25 | $1,258.93 |
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 $501.19 Median $549.54 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $776.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $758.58 |
Where Michigan sits
The same service costs 7.4 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.
Michigan· 34th of 51
$1,047
OK $3,890TX $525
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.