How much rates vary
Facilitymedian $3,162 · 10th to 90th $955 to $5,495Professionalmedian $1,072 · 10th to 90th $676 to $1,230
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 $1,071.52 Median $1,096.48 Typical High $6,918.31 | Facility | None | $1,071.52 | $1,096.48 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,096.48 | Professional | None | $954.99 | $1,096.48 | $1,096.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $5,495.41 | Facility | None | $3,162.28 | $3,162.28 | $5,495.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $218.78 Median $724.44 Typical High $1,148.15 | Professional | None | $218.78 | $724.44 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $2,630.27 | Professional | None | $616.60 | $954.99 | $2,630.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,047.13 Median $2,238.72 Typical High $4,897.79 | Facility | None | $1,047.13 | $2,238.72 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,288.25 | Professional | None | $831.76 | $1,047.13 | $1,288.25 |
Priority Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,202.26 | Professional | None | $616.60 | $954.99 | $1,202.26 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,025.60 | Facility | None | $660.69 | $1,548.82 | $6,025.60 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,380.38 | Professional | None | $954.99 | $1,122.02 | $1,380.38 |
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 $467.74 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $467.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $141.25 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Where Michigan sits
The same service costs 6.2 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· 35th of 51
$1,096
OK $3,631UT $589
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.