How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,349 to $12,023Professionalmedian $2,692 · 10th to 90th $1,202 to $4,266
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 $2,630.27 Median $4,897.79 Typical High $6,918.31 | Facility | None | $2,630.27 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,630.27 | $2,754.23 | $2,754.23 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $13,489.63 | Facility | None | $7,762.47 | $7,762.47 | $13,489.63 |
BCBS Michigan Setting Professional Modifier None Typical Low $562.34 Median $3,019.95 Typical High $4,265.80 | Professional | None | $562.34 | $3,019.95 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,584.89 | $2,454.71 | $3,388.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,981.07 Median $4,897.79 Typical High $6,165.95 | Facility | None | $3,981.07 | $4,897.79 | $6,165.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,691.53 | $2,951.21 |
Priority Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,584.89 | $2,089.30 | $3,235.94 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,202.26 | $2,238.72 | $2,754.23 |
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 $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,318.26 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $524.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,949.84 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $398.11 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,905.46 | $1,905.46 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | 50 · Both sides | $4,570.88 | $4,570.88 | $4,570.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,318.26 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $524.81 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,949.84 | $2,041.74 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $398.11 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,905.46 | $1,905.46 |
Where Michigan sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.