How much rates vary
Facilitymedian $1,622 · 10th to 90th $513 to $3,311Professionalmedian $550 · 10th to 90th $398 to $661
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 $549.54 Median $2,884.03 Typical High $4,897.79 | Facility | None | $549.54 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | None | $446.68 | $549.54 | $549.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,621.81 | $1,659.59 | $2,884.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $138.04 Median $645.65 Typical High $645.65 | Professional | None | $138.04 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $1,348.96 | Professional | None | $371.54 | $467.74 | $1,348.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $562.34 Median $1,412.54 Typical High $4,897.79 | Facility | None | $562.34 | $1,412.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $707.95 | Professional | None | $478.63 | $549.54 | $707.95 |
Priority Health Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $707.95 | Professional | None | $371.54 | $467.74 | $707.95 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $707.95 | Professional | None | $478.63 | $562.34 | $707.95 |
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 $239.88 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $109.65 | $112.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $416.87 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $56.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $389.05 |
Where Michigan sits
The same service costs 7.2 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· 32nd of 51
$562
OK $2,042UT $282
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.