How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,549 to $14,454Professionalmedian $2,630 · 10th to 90th $1,738 to $2,951
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 $2,570.40 Median $4,897.79 Typical High $6,918.31 | Facility | None | $2,570.40 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,570.40 | $2,691.53 | $2,691.53 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $13,489.63 | Facility | None | $7,762.47 | $7,762.47 | $13,489.63 |
BCBS Michigan Setting Professional Modifier None Typical Low $549.54 Median $2,630.27 Typical High $2,951.21 | Professional | None | $549.54 | $2,630.27 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,344.23 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,897.79 Median $6,309.57 Typical High $14,791.08 | Facility | None | $4,897.79 | $6,309.57 | $14,791.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,691.53 | $3,019.95 |
Priority Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,548.82 | $2,344.23 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $12,302.69 | Facility | None | $1,047.13 | $4,466.84 | $12,302.69 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,511.89 | $2,754.23 |
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 $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,288.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $512.86 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,949.84 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,862.09 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,288.25 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,949.84 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $389.05 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,862.09 | $1,862.09 |
Where Michigan sits
The same service costs 5.4 times more in Wyoming 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
WY $23,625KY $4,386
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.