How much rates vary
Facilitymedian $3,715 · 10th to 90th $646 to $6,166Professionalmedian $575 · 10th to 90th $407 to $912
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 $575.44 Median $575.44 Typical High $6,918.31 | Facility | None | $575.44 | $575.44 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $630.96 | Professional | None | $467.74 | $575.44 | $630.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $6,456.54 | Facility | None | $3,715.35 | $3,715.35 | $6,456.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $128.82 Median $645.65 Typical High $977.24 | Professional | None | $128.82 | $645.65 | $977.24 |
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 $338.84 Median $602.56 Typical High $1,548.82 | Professional | None | $338.84 | $602.56 | $1,548.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $5,888.44 | Facility | None | $575.44 | $1,412.54 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $707.95 | Professional | None | $457.09 | $575.44 | $707.95 |
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 $338.84 Median $524.81 Typical High $1,445.44 | Professional | None | $338.84 | $524.81 | $1,445.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $758.58 | Professional | None | $512.86 | $588.84 | $758.58 |
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 $263.03 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $407.38 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 50 · Both sides | $1,023.29 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
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
$603
OK $2,951UT $339
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.