How much rates vary
Facilitymedian $3,236 · 10th to 90th $912 to $6,166Professionalmedian $912 · 10th to 90th $631 to $1,072
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 $912.01 Median $954.99 Typical High $5,754.40 | Facility | None | $912.01 | $954.99 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | None | $812.83 | $912.01 | $912.01 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,623.41 | Facility | None | $3,235.94 | $3,311.31 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,000.00 | Professional | None | $630.96 | $954.99 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $2,290.87 | Professional | None | $537.03 | $954.99 | $2,290.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $1,949.84 Typical High $4,897.79 | Facility | None | $954.99 | $1,949.84 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,148.15 | Professional | None | $741.31 | $912.01 | $1,148.15 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $2,238.72 | Professional | None | $537.03 | $851.14 | $2,238.72 |
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 $812.83 Median $933.25 Typical High $1,202.26 | Professional | None | $812.83 | $933.25 | $1,202.26 |
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 $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $676.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
Where Michigan sits
The same service costs 8.7 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
$912
OK $4,365UT $501
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.