How much rates vary
Facilitymedian $1,479 · 10th to 90th $708 to $4,074Professionalmedian $525 · 10th to 90th $407 to $871
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 $524.81 Median $4,073.80 Typical High $5,754.40 | Facility | None | $524.81 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | None | $478.63 | $524.81 | $524.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,570.40 | Facility | None | $1,479.11 | $1,479.11 | $2,570.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $117.49 Median $831.76 Typical High $870.96 | Professional | None | $117.49 | $831.76 | $870.96 |
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 $302.00 Median $537.03 Typical High $1,318.26 | Professional | None | $302.00 | $537.03 | $1,318.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $4,897.79 | Facility | None | $1,023.29 | $1,318.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $630.96 | Professional | None | $407.38 | $524.81 | $630.96 |
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 $302.00 Median $467.74 Typical High $891.25 | Professional | None | $302.00 | $467.74 | $891.25 |
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 $457.09 Median $524.81 Typical High $676.08 | Professional | None | $457.09 | $524.81 | $676.08 |
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 $239.88 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $363.08 |
Where Michigan sits
The same service costs 6.0 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· 39th of 51
$537
OK $1,862UT $309
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.