How much rates vary
Facilitymedian $5,623 · 10th to 90th $912 to $9,120Professionalmedian $933 · 10th to 90th $661 to $1,072
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 $912.01 Median $954.99 Typical High $6,918.31 | Facility | None | $912.01 | $954.99 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | None | $851.14 | $977.24 | $977.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,623.41 Median $5,754.40 Typical High $9,772.37 | Facility | None | $5,623.41 | $5,754.40 | $9,772.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $181.97 Median $660.69 Typical High $1,071.52 | Professional | None | $181.97 | $660.69 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $2,344.23 | Professional | None | $575.44 | $851.14 | $2,344.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $4,897.79 | Facility | None | $1,862.09 | $2,951.21 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,148.15 | Professional | None | $741.31 | $933.25 | $1,148.15 |
Priority Health Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,202.26 | Professional | None | $575.44 | $851.14 | $1,202.26 |
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 $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | None | $831.76 | $1,000.00 | $1,258.93 |
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 $426.58 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $446.68 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $93.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $660.69 |
Where Michigan sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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· 33rd of 51
$955
OK $3,548TX $525
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.