How much rates vary
Facilitymedian $2,455 · 10th to 90th $891 to $4,898Professionalmedian $851 · 10th to 90th $603 to $1,514
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 $891.25 Median $912.01 Typical High $6,918.31 | Facility | None | $891.25 | $912.01 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | None | $724.44 | $912.01 | $912.01 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,265.80 | Facility | None | $2,454.71 | $2,454.71 | $4,265.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $204.17 Median $1,071.52 Typical High $1,513.56 | Professional | None | $204.17 | $1,071.52 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,621.81 | Professional | None | $512.86 | $776.25 | $1,621.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,737.80 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $977.24 | Professional | None | $691.83 | $870.96 | $977.24 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,230.27 | Professional | None | $512.86 | $776.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $912.01 | Professional | None | $707.95 | $812.83 | $912.01 |
13 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 $446.68 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $177.83 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $645.65 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,621.81 Typical High $2,570.40 | Professional | 50 · Both sides | $1,621.81 | $1,621.81 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $426.58 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $630.96 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $616.60 |
Where Michigan sits
The same service costs 4.8 times more in Alaska than in Montana. 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 $10,454MT $2,169
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.