How much rates vary
Facilitymedian $9,550 · 10th to 90th $501 to $14,791Professionalmedian $3,467 · 10th to 90th $741 to $4,074
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 $3,548.13 Median $3,630.78 Typical High $6,918.31 | Facility | None | $3,548.13 | $3,630.78 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $3,715.35 | Professional | None | $2,818.38 | $3,630.78 | $3,715.35 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,549.93 Median $9,772.37 Typical High $16,595.87 | Facility | None | $9,549.93 | $9,772.37 | $16,595.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $630.96 Median $3,467.37 Typical High $3,715.35 | Professional | None | $630.96 | $3,467.37 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $3,388.44 Typical High $4,073.80 | Professional | None | $1,995.26 | $3,388.44 | $4,073.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,388.44 Median $7,413.10 Typical High $8,317.64 | Facility | None | $3,388.44 | $7,413.10 | $8,317.64 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $4,168.69 | Professional | None | $2,818.38 | $3,388.44 | $4,168.69 |
Priority Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,511.89 | $4,073.80 |
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 $3,019.95 Median $3,890.45 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,890.45 | $4,570.88 |
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 $1,412.54 Median $1,819.70 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,412.54 | $1,819.70 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $724.44 Typical High $758.58 | Professional | 53 · Discontinued | $562.34 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,691.53 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,137.96 | $2,691.53 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $537.03 Typical High $562.34 | Professional | 55 · Aftercare only | $426.58 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $363.08 Typical High $371.54 | Professional | 56 · Pre-op care only | $281.84 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,511.89 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,511.89 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,698.24 | $1,737.80 | $1,737.80 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,511.89 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $501.19 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $338.84 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,454.71 | $2,454.71 |
Where Michigan sits
The same service costs 7.1 times more in Alaska 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
AK $22,023WA $3,113
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.