How much rates vary
Facilitymedian $10,715 · 10th to 90th $2,512 to $22,909Professionalmedian $1,413 · 10th to 90th $295 to $1,698
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 $1,412.54 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,412.54 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,445.44 | $1,479.11 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,332.54 Median $10,715.19 Typical High $27,542.29 | Facility | None | $9,332.54 | $10,715.19 | $27,542.29 |
BCBS Michigan Setting Professional Modifier None Typical Low $251.19 Median $1,412.54 Typical High $1,479.11 | Professional | None | $251.19 | $1,412.54 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,513.56 Typical High $1,862.09 | Professional | None | $831.76 | $1,513.56 | $1,862.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,445.44 | $3,467.37 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,412.54 | $1,778.28 |
Priority Health Setting Professional Modifier None Typical Low $831.76 Median $1,513.56 Typical High $1,778.28 | Professional | None | $831.76 | $1,513.56 | $1,778.28 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $891.25 | $2,818.38 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,380.38 | $1,819.70 |
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 $575.44 Median $724.44 Typical High $741.31 | Professional | 52 · Reduced service | $575.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $229.09 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,096.48 Typical High $1,122.02 | Professional | 54 · Surgery only | $870.96 | $1,096.48 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $218.78 Typical High $223.87 | Professional | 55 · Aftercare only | $173.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $114.82 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,023.29 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $812.83 | $1,023.29 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $630.96 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $1,000.00 | $1,000.00 |
Where Michigan sits
The same service costs 8.9 times more in Oklahoma than in Texas. 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
$1,479
OK $7,762TX $871
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.