How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,072 to $6,607Professionalmedian $1,148 · 10th to 90th $933 to $1,778
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 $1,071.52 Median $1,096.48 Typical High $6,918.31 | Facility | None | $1,071.52 | $1,096.48 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,071.52 | $1,122.02 | $1,122.02 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,623.41 | Facility | None | $3,235.94 | $3,311.31 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $1,778.28 | Professional | None | $691.83 | $1,174.90 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,513.56 | Professional | None | $660.69 | $1,023.29 | $1,513.56 |
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 $933.25 Median $1,148.15 Typical High $1,318.26 | Professional | None | $933.25 | $1,148.15 | $1,318.26 |
Priority Health Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,348.96 | Professional | None | $660.69 | $1,023.29 | $1,348.96 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,120.11 | Facility | None | $891.25 | $2,818.38 | $9,120.11 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,202.26 | Professional | None | $933.25 | $1,071.52 | $1,202.26 |
12 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 $537.03 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $794.33 |
Where Michigan sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.