How much rates vary
Facilitymedian $7,079 · 10th to 90th $501 to $11,220Professionalmedian $2,630 · 10th to 90th $1,698 to $3,162
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 $2,691.53 Median $2,754.23 Typical High $6,918.31 | Facility | None | $2,691.53 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,754.23 | $2,818.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,079.46 Median $7,244.36 Typical High $12,589.25 | Facility | None | $7,079.46 | $7,244.36 | $12,589.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $467.74 Median $2,630.27 Typical High $2,754.23 | Professional | None | $467.74 | $2,630.27 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,570.40 | $3,090.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $5,370.32 Typical High $5,888.44 | Facility | None | $2,570.40 | $5,370.32 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,949.84 | $2,398.83 | $2,818.38 |
Priority Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,905.46 | $3,090.30 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,344.23 | $2,951.21 | $3,715.35 |
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 $1,071.52 Median $1,380.38 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,071.52 | $1,380.38 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $549.54 Typical High $562.34 | Professional | 53 · Discontinued | $426.58 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,041.74 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,621.81 | $2,041.74 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $407.38 Typical High $426.58 | Professional | 55 · Aftercare only | $323.59 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $275.42 Typical High $281.84 | Professional | 56 · Pre-op care only | $213.80 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,905.46 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,905.46 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,288.25 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $512.86 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,905.46 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $380.19 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $257.04 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,862.09 | $1,862.09 |
Where Michigan sits
The same service costs 8.0 times more in Alabama than in Washington. 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
AL $20,353WA $2,540
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.