How much rates vary
Facilitymedian $4,266 · 10th to 90th $955 to $7,244Professionalmedian $1,096 · 10th to 90th $759 to $1,318
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 $1,148.15 Typical High $6,918.31 | Facility | None | $1,096.48 | $1,148.15 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,148.15 | $1,202.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,265.80 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $263.03 Median $1,318.26 Typical High $1,862.09 | Professional | None | $263.03 | $1,318.26 | $1,862.09 |
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 $676.08 Median $977.24 Typical High $1,862.09 | Professional | None | $676.08 | $977.24 | $1,862.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $4,897.79 | Facility | None | $1,778.28 | $1,778.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,202.26 | Professional | None | $831.76 | $1,096.48 | $1,202.26 |
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 $676.08 Median $954.99 Typical High $1,584.89 | Professional | None | $676.08 | $954.99 | $1,584.89 |
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 $891.25 Median $1,000.00 Typical High $1,122.02 | Professional | None | $891.25 | $1,000.00 | $1,122.02 |
12 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 $218.78 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $831.76 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $169.82 |
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 $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $562.34 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $223.87 | $234.42 | $234.42 |
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 $169.82 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $117.49 |
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 4.5 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 $12,963MT $2,892
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.