How much rates vary
Facilitymedian $3,631 · 10th to 90th $891 to $6,918Professionalmedian $759 · 10th to 90th $162 to $871
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 $758.58 Median $1,000.00 Typical High $6,918.31 | Facility | None | $758.58 | $1,000.00 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,630.78 Median $3,715.35 Typical High $6,309.57 | Facility | None | $3,630.78 | $3,715.35 | $6,309.57 |
BCBS Michigan Setting Professional Modifier None Typical Low $154.88 Median $691.83 Typical High $812.83 | Professional | None | $154.88 | $691.83 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,862.09 | Professional | None | $436.52 | $676.08 | $1,862.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $6,918.31 | Facility | None | $812.83 | $1,995.26 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $933.25 | Professional | None | $602.56 | $741.31 | $933.25 |
Priority Health Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $851.14 | Professional | None | $436.52 | $676.08 | $851.14 |
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 $660.69 Median $794.33 Typical High $977.24 | Professional | None | $660.69 | $794.33 | $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 $331.13 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where Michigan sits
The same service costs 9.8 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· 37th of 51
$776
OK $4,365UT $447
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.