How much rates vary
Facilitymedian $2,754 · 10th to 90th $912 to $5,129Professionalmedian $1,000 · 10th to 90th $692 to $1,148
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 $1,023.29 Median $2,041.74 Typical High $4,897.79 | Facility | None | $1,023.29 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $891.25 | $1,047.13 | $1,047.13 |
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 $223.87 Median $691.83 Typical High $1,096.48 | Professional | None | $223.87 | $691.83 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $2,511.89 | Professional | None | $575.44 | $912.01 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $4,897.79 | Facility | None | $1,949.84 | $2,041.74 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,202.26 | Professional | None | $794.33 | $1,000.00 | $1,202.26 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $1,148.15 | Professional | None | $575.44 | $912.01 | $1,148.15 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,244.36 | Facility | None | $660.69 | $1,548.82 | $7,244.36 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,318.26 | Professional | None | $891.25 | $1,047.13 | $1,318.26 |
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 $446.68 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $616.60 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Michigan sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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.
Physician feeFacility fee
OK $9,757HI $1,932
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.