How much rates vary
Facilitymedian $1,950 · 10th to 90th $550 to $4,074Professionalmedian $813 · 10th to 90th $617 to $1,445
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 $831.76 Median $4,073.80 Typical High $5,754.40 | Facility | None | $831.76 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $891.25 | Professional | None | $691.83 | $851.14 | $891.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $169.82 Median $1,000.00 Typical High $1,513.56 | Professional | None | $169.82 | $1,000.00 | $1,513.56 |
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 $501.19 Median $741.31 Typical High $1,318.26 | Professional | None | $501.19 | $741.31 | $1,318.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $1,621.81 Typical High $4,897.79 | Facility | None | $977.24 | $1,621.81 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $891.25 | Professional | None | $616.60 | $794.33 | $891.25 |
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 $501.19 Median $707.95 Typical High $1,174.90 | Professional | None | $501.19 | $707.95 | $1,174.90 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $4,168.69 | Facility | None | $426.58 | $602.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $812.83 | Professional | None | $660.69 | $724.44 | $812.83 |
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 $416.87 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $83.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $426.58 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $630.96 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $616.60 |
Where Michigan sits
The same service costs 4.3 times more in Alaska than in West Virginia. 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 $6,645WV $1,559
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.