How much rates vary
Facilitymedian $2,512 · 10th to 90th $955 to $4,898Professionalmedian $1,148 · 10th to 90th $871 to $2,089
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 $1,174.90 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,174.90 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,202.26 | $1,202.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $4,365.16 | Facility | None | $2,511.89 | $2,570.40 | $4,365.16 |
BCBS Michigan Setting Professional Modifier None Typical Low $870.96 Median $1,995.26 Typical High $2,089.30 | Professional | None | $870.96 | $1,995.26 | $2,089.30 |
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 $707.95 Median $1,047.13 Typical High $1,659.59 | Professional | None | $707.95 | $1,047.13 | $1,659.59 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $4,897.79 | Facility | None | $1,621.81 | $2,344.23 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,258.93 | Professional | None | $891.25 | $1,148.15 | $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 $707.95 Median $1,023.29 Typical High $1,513.56 | Professional | None | $707.95 | $1,023.29 | $1,513.56 |
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 $933.25 Median $1,047.13 Typical High $1,174.90 | Professional | None | $933.25 | $1,047.13 | $1,174.90 |
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 $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $588.84 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Where Michigan sits
The same service costs 3.1 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 $8,167HI $2,648
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.