How much rates vary
Facilitymedian $18,621 · 10th to 90th $1,349 to $28,840Professionalmedian $1,514 · 10th to 90th $1,148 to $2,291
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 $1,445.44 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,445.44 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,513.56 | $1,513.56 |
BCBS Michigan Setting Facility Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $32,359.37 | Facility | None | $18,620.87 | $18,620.87 | $32,359.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $323.59 Median $1,698.24 Typical High $2,398.83 | Professional | None | $323.59 | $1,698.24 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,995.26 | Professional | None | $870.96 | $1,348.96 | $1,995.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,951.21 Median $5,754.40 Typical High $9,332.54 | Facility | None | $2,951.21 | $5,754.40 | $9,332.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,479.11 | $1,659.59 |
Priority Health Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,819.70 | Professional | None | $870.96 | $1,348.96 | $1,819.70 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $12,589.25 | Facility | None | $891.25 | $2,818.38 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,380.38 | $1,513.56 |
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 $724.44 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,047.13 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 50 · Both sides | $2,570.40 | $2,570.40 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,047.13 |
Where Michigan sits
The same service costs 10.4 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 $29,118KY $2,808
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.