How much rates vary
Facilitymedian $2,138 · 10th to 90th $813 to $4,169Professionalmedian $871 · 10th to 90th $589 to $1,096
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 $794.33 Median $1,000.00 Typical High $5,754.40 | Facility | None | $794.33 | $1,000.00 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,047.13 | Professional | None | $812.83 | $851.14 | $1,047.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $3,801.89 | Facility | None | $2,137.96 | $2,187.76 | $3,801.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $158.49 Median $588.84 Typical High $933.25 | Professional | None | $158.49 | $588.84 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $977.24 | Professional | None | $537.03 | $691.83 | $977.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $4,897.79 | Facility | None | $954.99 | $2,089.30 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,122.02 | Professional | None | $794.33 | $977.24 | $1,122.02 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $977.24 | Professional | None | $537.03 | $707.95 | $977.24 |
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 $707.95 Median $851.14 Typical High $1,071.52 | Professional | None | $707.95 | $851.14 | $1,071.52 |
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 $398.11 Median $407.38 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $691.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $489.78 | Professional | 52 · Reduced service | $389.05 | $389.05 | $489.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $158.49 | $158.49 | $194.98 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $588.84 | $724.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $144.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $97.72 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $676.08 |
Where Michigan sits
The same service costs 3.1 times more in Alaska than in Maryland. 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 $5,990MD $1,938
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.