How much rates vary
Facilitymedian $1,445 · 10th to 90th $776 to $3,090Professionalmedian $355 · 10th to 90th $245 to $537
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 $346.74 Median $2,041.74 Typical High $4,897.79 | Facility | None | $346.74 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $371.54 | Professional | None | $288.40 | $371.54 | $371.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,511.89 | Facility | None | $1,445.44 | $1,479.11 | $2,511.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $83.18 Median $371.54 Typical High $588.84 | Professional | None | $83.18 | $371.54 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $977.24 | Professional | None | $218.78 | $371.54 | $977.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $4,897.79 | Facility | None | $724.44 | $1,174.90 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $446.68 | Professional | None | $295.12 | $354.81 | $446.68 |
Priority Health Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $870.96 | Professional | None | $218.78 | $309.03 | $870.96 |
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 $323.59 Median $354.81 Typical High $457.09 | Professional | None | $323.59 | $354.81 | $457.09 |
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 $147.91 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $147.91 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $60.26 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $223.87 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $29.51 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $208.93 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $173.78 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $69.18 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $51.29 | $53.70 | $53.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $35.48 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $239.88 | $251.19 | $251.19 |
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· 40th of 51
$372
OK $1,479UT $245
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.