How much rates vary
Facilitymedian $9,333 · 10th to 90th $1,122 to $14,454Professionalmedian $1,148 · 10th to 90th $891 to $1,862
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 $1,096.48 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,096.48 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,148.15 | $1,148.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $16,218.10 | Facility | None | $9,332.54 | $9,332.54 | $16,218.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $208.93 Median $1,318.26 Typical High $1,862.09 | Professional | None | $208.93 | $1,318.26 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $2,187.76 | Professional | None | $660.69 | $1,023.29 | $2,187.76 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,238.72 Median $4,897.79 Typical High $5,011.87 | Facility | None | $2,238.72 | $4,897.79 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,258.93 | Professional | None | $891.25 | $1,122.02 | $1,258.93 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,513.56 | Professional | None | $660.69 | $1,023.29 | $1,513.56 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $891.25 | $2,818.38 | $10,715.19 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,174.90 | Professional | None | $912.01 | $1,047.13 | $1,174.90 |
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 $549.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $812.83 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 50 · Both sides | $1,995.26 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $562.34 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $812.83 |
Where Michigan sits
The same service costs 7.5 times more in Alaska than in Hawaii. 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 $19,036HI $2,542
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.