How much rates vary
Facilitymedian $17,378 · 10th to 90th $1,514 to $26,915Professionalmedian $2,399 · 10th to 90th $1,862 to $3,631
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 $2,238.72 Median $4,897.79 Typical High $6,918.31 | Facility | None | $2,238.72 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,238.72 | $2,344.23 | $2,344.23 |
BCBS Michigan Setting Facility Modifier None Typical Low $17,378.01 Median $17,378.01 Typical High $30,199.52 | Facility | None | $17,378.01 | $17,378.01 | $30,199.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,454.71 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,380.38 | $2,137.96 | $3,019.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,570.88 Median $6,918.31 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,918.31 | $8,709.64 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $2,511.89 | Professional | None | $1,862.09 | $2,290.87 | $2,511.89 |
Priority Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,348.96 | $2,137.96 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $15,135.61 | Facility | None | $1,047.13 | $4,466.84 | $15,135.61 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $2,570.40 | Professional | None | $1,905.46 | $2,290.87 | $2,570.40 |
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 $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,122.02 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,698.24 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $223.87 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,659.59 | $1,659.59 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | 50 · Both sides | $3,890.45 | $3,890.45 | $3,890.45 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,122.02 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $457.09 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,698.24 | $1,778.28 | $1,778.28 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $223.87 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,659.59 | $1,659.59 |
Where Michigan sits
The same service costs 7.8 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 $31,233KY $3,989
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.