How much rates vary
Facilitymedian $2,692 · 10th to 90th $832 to $5,495Professionalmedian $724 · 10th to 90th $525 to $1,023
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 $724.44 Median $4,897.79 Typical High $6,918.31 | Facility | None | $724.44 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | None | $660.69 | $741.31 | $741.31 |
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 $141.25 Median $831.76 Typical High $1,258.93 | Professional | None | $141.25 | $831.76 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $1,698.24 | Professional | None | $436.52 | $724.44 | $1,698.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $5,754.40 | Facility | None | $1,380.38 | $1,862.09 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $851.14 | Professional | None | $562.34 | $724.44 | $851.14 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $1,548.82 | Professional | None | $436.52 | $602.56 | $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 $602.56 Median $691.83 Typical High $870.96 | Professional | None | $602.56 | $691.83 | $870.96 |
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 $331.13 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $331.13 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $524.81 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 50 · Both sides | $1,348.96 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
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· 34th of 51
$724
OK $3,631UT $417
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.