How much rates vary
Facilitymedian $2,692 · 10th to 90th $794 to $5,129Professionalmedian $631 · 10th to 90th $447 to $1,047
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 $630.96 Median $870.96 Typical High $6,918.31 | Facility | None | $630.96 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $630.96 | Professional | None | $549.54 | $630.96 | $630.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,691.53 Median $2,754.23 Typical High $4,677.35 | Facility | None | $2,691.53 | $2,754.23 | $4,677.35 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $741.31 Typical High $1,047.13 | Professional | None | $190.55 | $741.31 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $660.69 Typical High $1,584.89 | Professional | None | $363.08 | $660.69 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $4,897.79 | Facility | None | $1,230.27 | $1,862.09 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $758.58 | Professional | None | $501.19 | $630.96 | $758.58 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $1,548.82 | Professional | None | $363.08 | $575.44 | $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 $562.34 Median $645.65 Typical High $831.76 | Professional | None | $562.34 | $645.65 | $831.76 |
13 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 $288.40 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $288.40 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $436.52 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $436.52 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 50 · Both sides | $1,122.02 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $467.74 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $436.52 |
Where Michigan sits
The same service costs 10.0 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
$646
OK $3,631UT $363
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.