How much rates vary
Facilitymedian $2,512 · 10th to 90th $912 to $4,898Professionalmedian $1,047 · 10th to 90th $708 to $1,259
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 $1,047.13 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,047.13 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | None | $851.14 | $1,047.13 | $1,047.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $4,466.84 | Facility | None | $2,511.89 | $2,570.40 | $4,466.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $194.98 Median $707.95 Typical High $1,148.15 | Professional | None | $194.98 | $707.95 | $1,148.15 |
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 $602.56 Median $1,096.48 Typical High $2,630.27 | Professional | None | $602.56 | $1,096.48 | $2,630.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $4,897.79 | Facility | None | $1,949.84 | $2,187.76 | $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 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 $602.56 Median $954.99 Typical High $1,548.82 | Professional | None | $602.56 | $954.99 | $1,548.82 |
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 $933.25 Median $1,096.48 Typical High $1,412.54 | Professional | None | $933.25 | $1,096.48 | $1,412.54 |
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 $512.86 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $512.86 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $741.31 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
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 6.6 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
$1,047
OK $3,802UT $575
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.