How much rates vary
Facilitymedian $9,120 · 10th to 90th $501 to $14,125Professionalmedian $3,388 · 10th to 90th $2,188 to $3,981
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 $3,388.44 Median $3,467.37 Typical High $6,918.31 | Facility | None | $3,388.44 | $3,467.37 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $3,467.37 Typical High $3,630.78 | Professional | None | $2,290.87 | $3,467.37 | $3,630.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $9,120.11 Median $9,332.54 Typical High $15,848.93 | Facility | None | $9,120.11 | $9,332.54 | $15,848.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $602.56 Median $3,311.31 Typical High $3,548.13 | Professional | None | $602.56 | $3,311.31 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $3,235.94 Typical High $3,981.07 | Professional | None | $1,905.46 | $3,235.94 | $3,981.07 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,235.94 Median $7,079.46 Typical High $7,943.28 | Facility | None | $3,235.94 | $7,079.46 | $7,943.28 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $4,073.80 | Professional | None | $2,691.53 | $3,235.94 | $4,073.80 |
Priority Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,981.07 | Professional | None | $1,778.28 | $2,398.83 | $3,981.07 |
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 $2,884.03 Median $3,715.35 Typical High $4,365.16 | Professional | None | $2,884.03 | $3,715.35 | $4,365.16 |
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 $1,348.96 Median $1,737.80 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,348.96 | $1,737.80 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $691.83 Typical High $724.44 | Professional | 53 · Discontinued | $537.03 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,570.40 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,041.74 | $2,570.40 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $512.86 Typical High $537.03 | Professional | 55 · Aftercare only | $407.38 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $346.74 Typical High $354.81 | Professional | 56 · Pre-op care only | $269.15 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,398.83 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,398.83 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,621.81 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,621.81 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $645.65 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,398.83 | $2,511.89 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $489.78 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $323.59 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,344.23 | $2,344.23 |
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 $21,795WA $3,065
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.