How much rates vary
Facilitymedian $4,786 · 10th to 90th $933 to $7,586Professionalmedian $1,698 · 10th to 90th $1,230 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 $1,621.81 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,621.81 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,621.81 | $1,698.24 | $1,698.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,786.30 Median $4,897.79 Typical High $8,317.64 | Facility | None | $4,786.30 | $4,897.79 | $8,317.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,096.48 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $2,089.30 | Professional | None | $977.24 | $1,513.56 | $2,089.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $5,370.32 | Facility | None | $3,235.94 | $4,897.79 | $5,370.32 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,659.59 | $1,737.80 |
Priority Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,737.80 | Professional | None | $977.24 | $1,318.26 | $1,737.80 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,456.54 | Facility | None | $602.56 | $1,230.27 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,659.59 | $1,778.28 |
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 $812.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,174.90 | $1,174.90 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 50 · Both sides | $2,818.38 | $2,818.38 | $2,818.38 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,174.90 |
Where Michigan sits
The same service costs 6.1 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 $14,041TX $2,290
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.