How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,549 to $14,791Professionalmedian $1,413 · 10th to 90th $398 to $2,951
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 $1,778.28 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,778.28 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,778.28 | $1,862.09 | $1,862.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $14,454.40 | Facility | None | $8,317.64 | $8,317.64 | $14,454.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $398.11 Median $2,137.96 Typical High $2,951.21 | Professional | None | $398.11 | $2,137.96 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,412.54 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,691.53 Median $5,754.40 Typical High $14,791.08 | Facility | None | $2,691.53 | $5,754.40 | $14,791.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,380.38 | $1,819.70 |
Priority Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,348.96 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,570.88 Typical High $17,782.79 | Facility | None | $1,047.13 | $4,570.88 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,288.25 | $1,737.80 |
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 $891.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $891.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $354.81 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,318.26 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $177.83 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,318.26 | $1,318.26 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | 50 · Both sides | $3,162.28 | $3,162.28 | $3,162.28 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $870.96 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,318.26 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,288.25 | $1,288.25 |
Where Michigan sits
The same service costs 7.3 times more in Alabama 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
AL $22,698TX $3,114
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.