How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,349 to $15,488Professionalmedian $1,738 · 10th to 90th $1,349 to $2,512
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 $1,380.38 Median $1,445.44 Typical High $5,754.40 | Facility | None | $1,380.38 | $1,445.44 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,412.54 | $1,621.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $16,982.44 | Facility | None | $9,772.37 | $9,772.37 | $16,982.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,584.89 | $1,778.28 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,862.09 Typical High $3,388.44 | Professional | None | $870.96 | $1,862.09 | $3,388.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $4,073.80 Typical High $13,489.63 | Facility | None | $1,445.44 | $4,073.80 | $13,489.63 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,548.82 | $2,089.30 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $870.96 Median $1,698.24 Typical High $3,019.95 | Professional | None | $870.96 | $1,698.24 | $3,019.95 |
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 $1,621.81 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,819.70 | $2,454.71 |
14 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 $630.96 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $977.24 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 50 · Both sides | $2,630.27 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $7,762.47 Typical High $37,153.52 | Facility | 50 · Both sides | $2,951.21 | $7,762.47 | $37,153.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $676.08 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $954.99 |
Where Michigan sits
The same service costs 6.3 times more in Wyoming than in Hawaii. 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
WY $21,505HI $3,422
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.