How much rates vary
Facilitymedian $8,128 · 10th to 90th $1,288 to $20,893Professionalmedian $1,047 · 10th to 90th $708 to $1,698
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 $794.33 Median $1,047.13 Typical High $1,096.48 | Professional | None | $794.33 | $1,047.13 | $1,096.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,128.31 Median $10,232.93 Typical High $25,118.86 | Facility | None | $8,128.31 | $10,232.93 | $25,118.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $223.87 Median $1,202.26 Typical High $1,698.24 | Professional | None | $223.87 | $1,202.26 | $1,698.24 |
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 $602.56 Median $933.25 Typical High $2,630.27 | Professional | None | $602.56 | $933.25 | $2,630.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,995.26 Median $3,467.37 Typical High $4,897.79 | Facility | None | $1,995.26 | $3,467.37 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,148.15 | Professional | None | $812.83 | $1,023.29 | $1,148.15 |
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 $602.56 Median $933.25 Typical High $1,380.38 | Professional | None | $602.56 | $933.25 | $1,380.38 |
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 $831.76 Median $954.99 Typical High $1,071.52 | Professional | None | $831.76 | $954.99 | $1,071.52 |
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 $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $154.88 |
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 $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $724.44 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 50 · Both sides | $1,819.70 | $1,819.70 | $1,819.70 |
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 $199.53 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $154.88 |
Health Alliance Plan 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 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $724.44 |
Where Michigan sits
The same service costs 5.9 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 $14,644MT $2,489
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.