How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,202 to $9,772Professionalmedian $2,138 · 10th to 90th $1,445 to $2,630
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 $2,137.96 Median $4,897.79 Typical High $6,918.31 | Facility | None | $2,137.96 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,862.09 | $2,187.76 | $2,187.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,165.95 Median $6,309.57 Typical High $10,715.19 | Facility | None | $6,165.95 | $6,309.57 | $10,715.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $389.05 Median $2,290.87 Typical High $3,311.31 | Professional | None | $389.05 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,995.26 | $2,884.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,265.80 Median $5,248.07 Typical High $5,754.40 | Facility | None | $4,265.80 | $5,248.07 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,454.71 | Professional | None | $1,737.80 | $2,137.96 | $2,454.71 |
Priority Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,949.84 | $2,630.27 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,912.51 | Facility | None | $851.14 | $2,238.72 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,778.28 | $2,041.74 | $2,238.72 |
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 $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,047.13 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,548.82 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | 50 · Both sides | $3,715.35 | $3,715.35 | $3,715.35 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,047.13 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $426.58 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $208.93 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,548.82 |
Where Michigan sits
The same service costs 4.7 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 $16,761KY $3,604
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.