How much rates vary
Facilitymedian $38,905 · 10th to 90th $1,778 to $87,096Professionalmedian $1,230 · 10th to 90th $724 to $1,479
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 $1,258.93 Median $1,348.96 Typical High $6,918.31 | Facility | None | $1,258.93 | $1,348.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,380.38 | Professional | None | $912.01 | $1,288.25 | $1,380.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $38,904.51 Median $50,118.72 Typical High $120,226.44 | Facility | None | $38,904.51 | $50,118.72 | $120,226.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $245.47 Median $776.25 Typical High $1,230.27 | Professional | None | $245.47 | $776.25 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $1,479.11 | Professional | None | $707.95 | $1,230.27 | $1,479.11 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,348.96 Median $29,512.09 Typical High $51,286.14 | Facility | None | $1,348.96 | $29,512.09 | $51,286.14 |
Health Alliance Plan Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,513.56 | Professional | None | $954.99 | $1,202.26 | $1,513.56 |
Priority Health Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $30,199.52 | Professional | None | $660.69 | $1,230.27 | $30,199.52 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $10,964.78 Typical High $40,738.03 | Facility | None | $1,778.28 | $10,964.78 | $40,738.03 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,380.38 | $1,621.81 |
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 $512.86 Median $645.65 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $257.04 Typical High $263.03 | Professional | 53 · Discontinued | $204.17 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $776.25 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $154.88 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $128.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $102.33 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $724.44 | $891.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $602.56 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $239.88 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $912.01 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $870.96 |
Where Michigan sits
The same service costs 19.9 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 $53,750MT $2,699
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.