How much rates vary
Facilitymedian $3,802 · 10th to 90th $550 to $6,310Professionalmedian $955 · 10th to 90th $708 to $1,148
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 $954.99 Median $1,000.00 Typical High $4,897.79 | Facility | None | $954.99 | $1,000.00 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,096.48 | Professional | None | $776.25 | $954.99 | $1,096.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,801.89 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $194.98 Median $707.95 Typical High $1,148.15 | Professional | None | $194.98 | $707.95 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,174.90 | Professional | None | $602.56 | $851.14 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $7,413.10 | Facility | None | $954.99 | $2,238.72 | $7,413.10 |
Health Alliance Plan Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,148.15 | Professional | None | $831.76 | $977.24 | $1,148.15 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,288.25 | Professional | None | $602.56 | $851.14 | $1,288.25 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $4,570.88 | Facility | None | $426.58 | $602.56 | $4,570.88 |
United Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,174.90 | Professional | None | $831.76 | $933.25 | $1,174.90 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $676.08 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $812.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $186.21 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $660.69 |
Where Michigan sits
The same service costs 3.5 times more in Alaska than in Georgia. 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
AK $7,038GA $2,000
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.