How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,023 to $12,882Professionalmedian $794 · 10th to 90th $537 to $1,288
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 $794.33 Median $812.83 Typical High $6,918.31 | Facility | None | $794.33 | $812.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $812.83 | Professional | None | $537.03 | $602.56 | $812.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,943.28 Median $8,128.31 Typical High $13,803.84 | Facility | None | $7,943.28 | $8,128.31 | $13,803.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $151.36 Median $954.99 Typical High $1,348.96 | Professional | None | $151.36 | $954.99 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,737.80 | Professional | None | $457.09 | $724.44 | $1,737.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $812.83 Median $3,311.31 Typical High $4,897.79 | Facility | None | $812.83 | $3,311.31 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $851.14 | Professional | None | $537.03 | $741.31 | $851.14 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,071.52 | Professional | None | $457.09 | $724.44 | $1,071.52 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $891.25 | $2,818.38 | $10,715.19 |
United Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $851.14 | Professional | None | $660.69 | $758.58 | $851.14 |
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 $398.11 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $398.11 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $562.34 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 50 · Both sides | $1,445.44 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $588.84 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $562.34 |
Where Michigan sits
The same service costs 10.1 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 $19,890MT $1,977
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.