How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,230 to $8,128Professionalmedian $1,047 · 10th to 90th $832 to $1,660
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 $1,000.00 Median $1,047.13 Typical High $6,918.31 | Facility | None | $1,000.00 | $1,047.13 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | None | $851.14 | $1,047.13 | $1,047.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $5,248.07 | Facility | None | $3,019.95 | $3,019.95 | $5,248.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $223.87 Median $1,584.89 Typical High $1,659.59 | Professional | None | $223.87 | $1,584.89 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,445.44 | Professional | None | $616.60 | $954.99 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $4,897.79 | Facility | None | $1,778.28 | $1,778.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,230.27 | Professional | None | $870.96 | $1,047.13 | $1,230.27 |
Priority Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,230.27 | Professional | None | $616.60 | $954.99 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,073.80 Typical High $10,232.93 | Facility | None | $1,047.13 | $4,073.80 | $10,232.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,122.02 | Professional | None | $870.96 | $1,000.00 | $1,122.02 |
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 $501.19 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $741.31 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 50 · Both sides | $1,778.28 | $1,778.28 | $1,778.28 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $741.31 |
Where Michigan sits
The same service costs 4.3 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 $9,769TX $2,271
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.