How much rates vary
Facilitymedian $1,660 · 10th to 90th $550 to $4,074Professionalmedian $1,820 · 10th to 90th $1,230 to $3,020
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 $1,819.70 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,819.70 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,819.70 | $1,905.46 | $1,905.46 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,019.95 | Facility | None | $1,659.59 | $1,659.59 | $3,019.95 |
BCBS Michigan Setting Professional Modifier None Typical Low $398.11 Median $2,818.38 Typical High $3,019.95 | Professional | None | $398.11 | $2,818.38 | $3,019.95 |
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 $1,047.13 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,479.11 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $4,897.79 | Facility | None | $954.99 | $3,715.35 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,778.28 | $1,995.26 |
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 $1,047.13 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,380.38 | $2,089.30 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,801.89 | Facility | None | $426.58 | $602.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,513.56 | $1,819.70 |
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 $912.01 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $912.01 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,380.38 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,318.26 | $1,318.26 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 50 · Both sides | $3,235.94 | $3,235.94 | $3,235.94 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $870.96 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,258.93 |
Where Michigan sits
The same service costs 3.7 times more in Alaska than in Delaware. 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 $8,917DE $2,410
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.