How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,047 to $7,244Professionalmedian $741 · 10th to 90th $513 to $813
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 $575.44 Median $870.96 Typical High $6,918.31 | Facility | None | $575.44 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $758.58 | Professional | None | $575.44 | $758.58 | $758.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $162.18 Median $512.86 Typical High $812.83 | Professional | None | $162.18 | $512.86 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $2,041.74 | Professional | None | $446.68 | $794.33 | $2,041.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,513.56 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,513.56 | $2,884.03 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $851.14 | Professional | None | $602.56 | $758.58 | $851.14 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $1,819.70 | Professional | None | $446.68 | $724.44 | $1,819.70 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,000.00 | Facility | None | $891.25 | $2,818.38 | $10,000.00 |
United Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $933.25 | Professional | None | $645.65 | $707.95 | $933.25 |
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 $281.84 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $281.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $114.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $426.58 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $85.11 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $398.11 | $524.81 | $537.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $575.44 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $537.03 |
Where Michigan sits
The same service costs 8.1 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· 38th of 51
$759
OK $3,467UT $427
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.