How much rates vary
Facilitymedian $2,692 · 10th to 90th $794 to $5,370Professionalmedian $550 · 10th to 90th $380 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 $549.54 Median $870.96 Typical High $6,918.31 | Facility | None | $549.54 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | None | $489.78 | $549.54 | $549.54 |
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 $123.03 Median $870.96 Typical High $912.01 | Professional | None | $123.03 | $870.96 | $912.01 |
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 $316.23 Median $575.44 Typical High $1,548.82 | Professional | None | $316.23 | $575.44 | $1,548.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $4,897.79 | Facility | None | $1,071.52 | $1,862.09 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $676.08 | Professional | None | $436.52 | $549.54 | $676.08 |
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 $316.23 Median $501.19 Typical High $1,380.38 | Professional | None | $316.23 | $501.19 | $1,380.38 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $707.95 | Professional | None | $489.78 | $562.34 | $707.95 |
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 $251.19 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
Where Michigan sits
The same service costs 9.8 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· 41st of 51
$562
OK $3,236UT $331
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.