How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,023 to $6,918Professionalmedian $1,023 · 10th to 90th $692 to $1,660
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 $1,000.00 Median $1,380.38 Typical High $6,918.31 | Facility | None | $1,000.00 | $1,380.38 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,047.13 | Professional | None | $891.25 | $1,023.29 | $1,047.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,623.41 | Facility | None | $3,235.94 | $3,311.31 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $186.21 Median $1,096.48 Typical High $1,659.59 | Professional | None | $186.21 | $1,096.48 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $2,570.40 | Professional | None | $602.56 | $954.99 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,071.52 Median $2,570.40 Typical High $6,918.31 | Facility | None | $1,071.52 | $2,570.40 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,174.90 | Professional | None | $831.76 | $1,047.13 | $1,174.90 |
Priority Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Priority Health Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,318.26 | Professional | None | $602.56 | $933.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,071.52 | Professional | None | $831.76 | $912.01 | $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 $501.19 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $501.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $100.00 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $724.44 |
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 $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
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 4.9 times more in Alaska than in Kentucky. 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 $10,315KY $2,095
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.