How much rates vary
Facilitymedian $8,128 · 10th to 90th $501 to $12,589Professionalmedian $2,884 · 10th to 90th $1,950 to $3,548
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 $3,019.95 Median $3,019.95 Typical High $6,918.31 | Facility | None | $3,019.95 | $3,019.95 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,162.28 | Professional | None | $2,398.83 | $3,019.95 | $3,162.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,128.31 Median $8,317.64 Typical High $14,125.38 | Facility | None | $8,128.31 | $8,317.64 | $14,125.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $616.60 Median $1,949.84 Typical High $3,090.30 | Professional | None | $616.60 | $1,949.84 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,884.03 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,884.03 Median $6,456.54 Typical High $7,079.46 | Facility | None | $2,884.03 | $6,456.54 | $7,079.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,398.83 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,398.83 | $2,884.03 | $3,548.13 |
Priority Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,584.89 | $2,137.96 | $3,467.37 |
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 $2,630.27 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,388.44 | $3,801.89 |
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 $1,202.26 Median $1,513.56 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,202.26 | $1,513.56 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $616.60 Typical High $630.96 | Professional | 53 · Discontinued | $478.63 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,290.87 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,778.28 | $2,290.87 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $457.09 Typical High $478.63 | Professional | 55 · Aftercare only | $354.81 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $302.00 Typical High $316.23 | Professional | 56 · Pre-op care only | $239.88 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,137.96 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,137.96 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,412.54 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $575.44 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,137.96 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $426.58 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $288.40 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,089.30 | $2,089.30 |
Where Michigan sits
The same service costs 6.7 times more in Alabama than in Maryland. 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 $20,667MD $3,074
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.