How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,349 to $8,128Professionalmedian $1,549 · 10th to 90th $1,230 to $2,455
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 $1,513.56 Median $1,548.82 Typical High $6,918.31 | Facility | None | $1,513.56 | $1,548.82 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,513.56 | $1,548.82 | $1,548.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,365.16 Median $4,466.84 Typical High $7,585.78 | Facility | None | $4,365.16 | $4,466.84 | $7,585.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $977.24 Median $1,778.28 Typical High $2,454.71 | Professional | None | $977.24 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,041.74 | Professional | None | $891.25 | $1,412.54 | $2,041.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,019.95 Median $4,897.79 Typical High $5,128.61 | Facility | None | $3,019.95 | $4,897.79 | $5,128.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,513.56 | $1,737.80 |
Priority Health Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $1,862.09 | Professional | None | $891.25 | $1,380.38 | $1,862.09 |
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 $1,258.93 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,445.44 | $1,584.89 |
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 $758.58 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $758.58 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,096.48 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 50 · Both sides | $2,630.27 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $758.58 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $151.36 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,096.48 |
Where Michigan sits
The same service costs 5.5 times more in Alaska than in Texas. 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 $14,559TX $2,668
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.