How much rates vary
Facilitymedian $2,754 · 10th to 90th $794 to $4,898Professionalmedian $550 · 10th to 90th $380 to $631
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 $562.34 Median $2,884.03 Typical High $4,897.79 | Facility | None | $562.34 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $562.34 | Professional | None | $489.78 | $562.34 | $562.34 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $4,897.79 | Facility | None | $2,754.23 | $2,818.38 | $4,897.79 |
BCBS Michigan Setting Professional Modifier None Typical Low $120.23 Median $575.44 Typical High $602.56 | Professional | None | $120.23 | $575.44 | $602.56 |
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 $316.23 Median $562.34 Typical High $1,548.82 | Professional | None | $316.23 | $562.34 | $1,548.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,071.52 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $660.69 | Professional | None | $426.58 | $537.03 | $660.69 |
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 $316.23 Median $501.19 Typical High $1,348.96 | Professional | None | $316.23 | $501.19 | $1,348.96 |
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 $478.63 Median $575.44 Typical High $707.95 | Professional | None | $478.63 | $575.44 | $707.95 |
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 $245.47 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
Where Michigan sits
The same service costs 8.9 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· 36th of 51
$562
OK $2,951UT $331
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.