How much rates vary
Facilitymedian $10,471 · 10th to 90th $501 to $16,218Professionalmedian $3,802 · 10th to 90th $2,455 to $4,467
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 $3,801.89 Median $3,890.45 Typical High $6,918.31 | Facility | None | $3,801.89 | $3,890.45 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,890.45 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,890.45 | $4,073.80 |
BCBS Michigan Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $18,197.01 | Facility | None | $10,471.29 | $10,471.29 | $18,197.01 |
BCBS Michigan Setting Professional Modifier None Typical Low $676.08 Median $3,981.07 Typical High $3,981.07 | Professional | None | $676.08 | $3,981.07 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,715.35 Typical High $4,466.84 | Professional | None | $2,137.96 | $3,715.35 | $4,466.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,630.78 Median $7,943.28 Typical High $8,912.51 | Facility | None | $3,630.78 | $7,943.28 | $8,912.51 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,019.95 Median $3,630.78 Typical High $4,466.84 | Professional | None | $3,019.95 | $3,630.78 | $4,466.84 |
Priority Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,754.23 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,754.23 | $4,466.84 |
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 $3,162.28 Median $4,168.69 Typical High $4,897.79 | Professional | None | $3,162.28 | $4,168.69 | $4,897.79 |
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 $1,513.56 Median $1,949.84 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,513.56 | $1,949.84 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $776.25 Typical High $812.83 | Professional | 53 · Discontinued | $616.60 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,951.21 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,290.87 | $2,951.21 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $588.84 Typical High $602.56 | Professional | 55 · Aftercare only | $457.09 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $389.05 Typical High $407.38 | Professional | 56 · Pre-op care only | $309.03 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,754.23 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,754.23 | $2,818.38 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,819.70 | $1,905.46 | $1,905.46 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,754.23 | $2,818.38 | $2,818.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $549.54 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $363.08 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,630.27 | $2,630.27 |
Where Michigan sits
The same service costs 6.9 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 $22,987WA $3,314
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.