How much rates vary
Facilitymedian $1,950 · 10th to 90th $646 to $4,169Professionalmedian $525 · 10th to 90th $355 to $813
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 $467.74 Median $691.83 Typical High $4,897.79 | Facility | None | $467.74 | $691.83 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $691.83 | Professional | None | $309.03 | $478.63 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $91.20 Median $575.44 Typical High $933.25 | Professional | None | $91.20 | $575.44 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $954.99 | Professional | None | $295.12 | $524.81 | $954.99 |
Health Alliance Plan Setting Facility Modifier None Typical Low $478.63 Median $1,258.93 Typical High $5,754.40 | Facility | None | $478.63 | $1,258.93 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $707.95 | Professional | None | $354.81 | $524.81 | $707.95 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $269.15 Median $467.74 Typical High $776.25 | Professional | None | $269.15 | $467.74 | $776.25 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,456.54 | Facility | None | $602.56 | $1,230.27 | $6,456.54 |
United Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $676.08 | Professional | None | $407.38 | $524.81 | $676.08 |
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 $234.42 Median $245.47 Typical High $346.74 | Professional | 52 · Reduced service | $234.42 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $138.04 | Professional | 53 · Discontinued | $93.33 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $104.71 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $69.18 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $478.63 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $870.96 Typical High $1,412.54 | Professional | 50 · Both sides | $870.96 | $870.96 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $239.88 Typical High $346.74 | Professional | 52 · Reduced service | $229.09 | $239.88 | $346.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $141.25 | Professional | 53 · Discontinued | $91.20 | $95.50 | $141.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $354.81 Typical High $524.81 | Professional | 54 · Surgery only | $346.74 | $354.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $104.71 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $104.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $70.79 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $70.79 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $331.13 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $323.59 | $331.13 | $489.78 |
Where Michigan sits
The same service costs 6.4 times more in Alaska than in Montana. 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 $8,723MT $1,361
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.