How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,122 to $6,918Professionalmedian $1,349 · 10th to 90th $263 to $1,549
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 $1,412.54 Median $1,513.56 Typical High $6,918.31 | Facility | None | $1,412.54 | $1,513.56 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,445.44 | $1,513.56 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $1,548.82 | Professional | None | $263.03 | $309.03 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $3,467.37 | Professional | None | $831.76 | $1,380.38 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $4,897.79 | Facility | None | $2,187.76 | $2,187.76 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,348.96 | $1,479.11 |
Priority Health Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,570.40 | Professional | None | $831.76 | $1,230.27 | $2,570.40 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,318.26 | $1,778.28 |
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 $660.69 Median $724.44 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $691.83 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,023.29 |
Where Michigan sits
The same service costs 3.4 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 $11,546MT $3,436
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.