How much rates vary
Facilitymedian $724 · 10th to 90th $490 to $2,884Professionalmedian $224 · 10th to 90th $174 to $263
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 $218.78 Median $2,884.03 Typical High $4,897.79 | Facility | None | $218.78 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $245.47 | Professional | None | $173.78 | $234.42 | $245.47 |
BCBS Michigan Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,230.27 | Facility | None | $707.95 | $724.44 | $1,230.27 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $245.47 | Professional | None | $190.55 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $616.60 | Professional | None | $138.04 | $223.87 | $616.60 |
Health Alliance Plan Setting Facility Modifier None Typical Low $436.52 Median $741.31 Typical High $4,897.79 | Facility | None | $436.52 | $741.31 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $251.19 | Professional | None | $173.78 | $223.87 | $251.19 |
Priority Health Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $549.54 | Professional | None | $138.04 | $190.55 | $549.54 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,801.89 | Facility | None | $426.58 | $602.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $281.84 | Professional | None | $194.98 | $218.78 | $281.84 |
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 $95.50 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $95.50 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $38.02 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $131.83 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $112.20 | $112.20 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $42.66 | $44.67 | $44.67 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $162.18 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $32.36 | $33.88 | $33.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $22.39 | $22.39 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $151.36 | $158.49 | $158.49 |
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· 37th of 51
$234
OK $1,349UT $155
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.