How much rates vary
Facilitymedian $2,188 · 10th to 90th $813 to $4,365Professionalmedian $457 · 10th to 90th $324 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 $446.68 Median $2,884.03 Typical High $4,897.79 | Facility | None | $446.68 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $478.63 | Professional | None | $363.08 | $478.63 | $478.63 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $3,801.89 | Facility | None | $2,187.76 | $2,238.72 | $3,801.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $102.33 Median $489.78 Typical High $512.86 | Professional | None | $102.33 | $489.78 | $512.86 |
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 $281.84 Median $489.78 Typical High $1,258.93 | Professional | None | $281.84 | $489.78 | $1,258.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $2,041.74 Typical High $4,897.79 | Facility | None | $954.99 | $2,041.74 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $549.54 | Professional | None | $380.19 | $457.09 | $549.54 |
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 $281.84 Median $398.11 Typical High $1,122.02 | Professional | None | $281.84 | $398.11 | $1,122.02 |
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 $416.87 Median $467.74 Typical High $588.84 | Professional | None | $416.87 | $467.74 | $588.84 |
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 $204.17 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $89.13 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $331.13 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $69.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $45.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $323.59 |
Where Michigan sits
The same service costs 7.1 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· 36th of 51
$479
OK $1,950UT $275
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.