How much rates vary
Facilitymedian $2,754 · 10th to 90th $912 to $5,370Professionalmedian $1,202 · 10th to 90th $813 to $1,445
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 $1,202.26 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,202.26 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,071.52 | $1,202.26 | $1,202.26 |
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 $263.03 Median $1,023.29 Typical High $1,318.26 | Professional | None | $263.03 | $1,023.29 | $1,318.26 |
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 $691.83 Median $1,258.93 Typical High $3,019.95 | Professional | None | $691.83 | $1,258.93 | $3,019.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,949.84 | $2,511.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,513.56 | Professional | None | $954.99 | $1,202.26 | $1,513.56 |
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 $691.83 Median $1,122.02 Typical High $2,238.72 | Professional | None | $691.83 | $1,122.02 | $2,238.72 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,943.28 | Facility | None | $660.69 | $1,548.82 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,288.25 | $1,584.89 |
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 $588.84 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Where Michigan sits
The same service costs 6.3 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
$1,202
OK $4,169UT $661
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.