How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,349 to $14,125Professionalmedian $3,162 · 10th to 90th $2,239 to $3,548
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 $3,162.28 Median $4,897.79 Typical High $6,918.31 | Facility | None | $3,162.28 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,162.28 | $3,388.44 | $3,388.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,120.11 Median $9,332.54 Typical High $16,218.10 | Facility | None | $9,120.11 | $9,332.54 | $16,218.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $707.95 Median $3,548.13 Typical High $3,548.13 | Professional | None | $707.95 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,884.03 Typical High $3,890.45 | Professional | None | $1,949.84 | $2,884.03 | $3,890.45 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,981.07 Median $4,897.79 Typical High $7,244.36 | Facility | None | $3,981.07 | $4,897.79 | $7,244.36 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $3,467.37 | Professional | None | $2,454.71 | $3,162.28 | $3,467.37 |
Priority Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $3,801.89 | Professional | None | $1,949.84 | $2,818.38 | $3,801.89 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $3,235.94 | Professional | None | $2,570.40 | $2,951.21 | $3,235.94 |
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 $1,584.89 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,584.89 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,398.83 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,398.83 | $2,398.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,584.89 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $630.96 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,398.83 | $2,454.71 | $2,454.71 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $478.63 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $316.23 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,290.87 | $2,290.87 |
Where Michigan sits
The same service costs 4.0 times more in Alaska 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.
Physician feeFacility fee
AK $19,772TX $4,915
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.