How much rates vary
Facilitymedian $2,239 · 10th to 90th $955 to $4,677Professionalmedian $891 · 10th to 90th $603 to $1,778
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 $1,071.52 Typical High $6,918.31 | Facility | None | $1,047.13 | $1,071.52 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,122.02 | Professional | None | $812.83 | $1,071.52 | $1,122.02 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,238.72 Median $2,290.87 Typical High $3,981.07 | Facility | None | $2,238.72 | $2,290.87 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $234.42 Median $1,659.59 Typical High $1,778.28 | Professional | None | $234.42 | $1,659.59 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,318.26 | Professional | None | $549.54 | $758.58 | $1,318.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $4,897.79 | Facility | None | $1,445.44 | $1,445.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,023.29 | Professional | None | $602.56 | $794.33 | $1,023.29 |
Priority Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,318.26 | Professional | None | $537.03 | $676.08 | $1,318.26 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,122.02 | Professional | None | $676.08 | $870.96 | $1,122.02 |
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 $407.38 Median $537.03 Typical High $562.34 | Professional | 52 · Reduced service | $407.38 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $213.80 Typical High $229.09 | Professional | 53 · Discontinued | $165.96 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $616.60 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $123.03 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $81.28 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $741.31 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $575.44 | $741.31 | $794.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $741.31 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $707.95 |
Where Michigan sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. 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· 38th of 51
$977
OK $4,169KY $617
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.