How much rates vary
Facilitymedian $7,413 · 10th to 90th $813 to $15,849Professionalmedian $933 · 10th to 90th $575 to $1,318
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 $776.25 Median $1,258.93 Typical High $5,754.40 | Facility | None | $776.25 | $1,258.93 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,258.93 | Professional | None | $575.44 | $776.25 | $1,258.93 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,413.10 Median $9,549.93 Typical High $23,442.29 | Facility | None | $7,413.10 | $9,549.93 | $23,442.29 |
BCBS Michigan Setting Professional Modifier None Typical Low $173.78 Median $1,230.27 Typical High $1,698.24 | Professional | None | $173.78 | $1,230.27 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $891.25 Typical High $1,778.28 | Professional | None | $501.19 | $891.25 | $1,778.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $4,570.88 Typical High $13,803.84 | Facility | None | $954.99 | $4,570.88 | $13,803.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,288.25 | Professional | None | $602.56 | $954.99 | $1,288.25 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $467.74 Median $831.76 Typical High $1,348.96 | Professional | None | $467.74 | $831.76 | $1,348.96 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,584.89 Typical High $7,762.47 | Facility | None | $660.69 | $1,584.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,230.27 | Professional | None | $676.08 | $933.25 | $1,230.27 |
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 $380.19 Median $457.09 Typical High $630.96 | Professional | 52 · Reduced service | $380.19 | $457.09 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $181.97 Typical High $251.19 | Professional | 53 · Discontinued | $151.36 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $933.25 | Professional | 54 · Surgery only | $575.44 | $676.08 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $190.55 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $91.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $75.86 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $870.96 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,412.54 Typical High $2,570.40 | Professional | 50 · Both sides | $1,412.54 | $1,412.54 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $426.58 Typical High $645.65 | Professional | 52 · Reduced service | $371.54 | $426.58 | $645.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $257.04 | Professional | 53 · Discontinued | $151.36 | $173.78 | $257.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $977.24 | Professional | 54 · Surgery only | $562.34 | $645.65 | $977.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $194.98 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $194.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $128.82 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $128.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $912.01 |
Where Michigan sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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 $10,217WV $2,002
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.