How much rates vary
Facilitymedian $2,291 · 10th to 90th $955 to $4,677Professionalmedian $1,318 · 10th to 90th $617 to $2,692
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 $2,884.03 Typical High $4,897.79 | Facility | None | $1,621.81 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,621.81 | $1,659.59 | $1,659.59 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,981.07 | Facility | None | $2,290.87 | $2,290.87 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $302.00 Median $1,905.46 Typical High $2,691.53 | Professional | None | $302.00 | $1,905.46 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,445.44 Typical High $2,089.30 | Professional | None | $707.95 | $1,445.44 | $2,089.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,621.81 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,659.59 | Professional | None | $616.60 | $812.83 | $1,659.59 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,041.74 | Professional | None | $954.99 | $1,288.25 | $2,041.74 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $1,659.59 | Professional | None | $707.95 | $1,258.93 | $1,659.59 |
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 $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $323.59 | $331.13 | $331.13 |
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 $239.88 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $162.18 | $165.96 | $165.96 |
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 $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $831.76 | $831.76 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $323.59 | $331.13 | $331.13 |
Health Alliance Plan 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 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $162.18 | $165.96 | $165.96 |
Health Alliance Plan 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 |
Where Michigan sits
The same service costs 3.7 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 $9,494KY $2,537
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.