How much rates vary
Facilitymedian $1,995 · 10th to 90th $813 to $4,074Professionalmedian $513 · 10th to 90th $117 to $617
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 $512.86 Median $4,073.80 Typical High $5,754.40 | Facility | None | $512.86 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $549.54 | Professional | None | $426.58 | $549.54 | $549.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,995.26 | $1,995.26 | $3,467.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $100.00 Median $371.54 Typical High $588.84 | Professional | None | $100.00 | $371.54 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $1,412.54 | Professional | None | $323.59 | $537.03 | $1,412.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $4,073.80 | Facility | None | $1,148.15 | $2,041.74 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $630.96 | Professional | None | $416.87 | $524.81 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $1,288.25 | Professional | None | $323.59 | $457.09 | $1,288.25 |
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 $457.09 Median $524.81 Typical High $660.69 | Professional | None | $457.09 | $524.81 | $660.69 |
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 $218.78 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $218.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $89.13 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $43.65 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $257.04 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $102.33 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $380.19 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $52.48 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $354.81 | $371.54 | $371.54 |
Where Michigan sits
The same service costs 10.2 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
$525
OK $2,951UT $288
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.