How much rates vary
Facilitymedian $1,950 · 10th to 90th $977 to $5,495Professionalmedian $1,000 · 10th to 90th $661 to $1,585
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 $1,023.29 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,023.29 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,023.29 | $1,047.13 | $1,047.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $5,623.41 | Facility | None | $1,819.70 | $2,344.23 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $630.96 Median $1,122.02 Typical High $1,584.89 | Professional | None | $630.96 | $1,122.02 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $2,344.23 | Professional | None | $562.34 | $912.01 | $2,344.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $4,897.79 | Facility | None | $1,023.29 | $1,949.84 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,047.13 | Professional | None | $741.31 | $954.99 | $1,047.13 |
Priority Health Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $2,344.23 | Professional | None | $537.03 | $851.14 | $2,344.23 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,230.27 | Professional | None | $870.96 | $977.24 | $1,230.27 |
13 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 $512.86 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $512.86 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $741.31 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 50 · Both sides | $1,698.24 | $1,698.24 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $512.86 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $741.31 |
Where Michigan sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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.
Physician feeFacility fee
OK $7,181MS $1,948
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.