How much rates vary
Facilitymedian $1,096 · 10th to 90th $550 to $2,630Professionalmedian $1,023 · 10th to 90th $794 to $1,738
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 $977.24 Median $1,071.52 Typical High $4,897.79 | Facility | None | $977.24 | $1,071.52 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,071.52 | Professional | None | $794.33 | $1,000.00 | $1,071.52 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,949.84 | Facility | None | $1,096.48 | $1,122.02 | $1,949.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $199.53 Median $1,230.27 Typical High $1,737.80 | Professional | None | $199.53 | $1,230.27 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,445.44 | Professional | None | $588.84 | $912.01 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $4,897.79 | Facility | None | $1,071.52 | $1,995.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,122.02 | Professional | None | $794.33 | $1,000.00 | $1,122.02 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Professional | None | $588.84 | $812.83 | $1,202.26 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,047.13 | Professional | None | $812.83 | $933.25 | $1,047.13 |
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 $489.78 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $707.95 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 50 · Both sides | $1,862.09 | $1,862.09 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $707.95 |
Where Michigan sits
The same service costs 3.6 times more in Alaska than in Alabama. 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 $5,545AL $1,558
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.