How much rates vary
Facilitymedian $10,000 · 10th to 90th $501 to $15,488Professionalmedian $3,631 · 10th to 90th $2,399 to $4,266
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 $3,630.78 Median $3,715.35 Typical High $6,918.31 | Facility | None | $3,630.78 | $3,715.35 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,890.45 Typical High $3,890.45 | Professional | None | $2,951.21 | $3,890.45 | $3,890.45 |
BCBS Michigan Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $17,378.01 | Facility | None | $10,000.00 | $10,000.00 | $17,378.01 |
BCBS Michigan Setting Professional Modifier None Typical Low $758.58 Median $3,801.89 Typical High $3,801.89 | Professional | None | $758.58 | $3,801.89 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $3,548.13 Typical High $4,265.80 | Professional | None | $2,041.74 | $3,548.13 | $4,265.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,467.37 Median $7,762.47 Typical High $8,709.64 | Facility | None | $3,467.37 | $7,762.47 | $8,709.64 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $4,466.84 | Professional | None | $2,951.21 | $3,467.37 | $4,466.84 |
Priority Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,630.27 | $4,265.80 |
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 $3,235.94 Median $4,073.80 Typical High $4,677.35 | Professional | None | $3,235.94 | $4,073.80 | $4,677.35 |
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 $1,479.11 Median $1,862.09 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,479.11 | $1,862.09 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $741.31 Typical High $776.25 | Professional | 53 · Discontinued | $588.84 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,818.38 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,187.76 | $2,818.38 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $562.34 Typical High $588.84 | Professional | 55 · Aftercare only | $436.52 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $371.54 Typical High $389.05 | Professional | 56 · Pre-op care only | $295.12 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,630.27 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,630.27 | $2,691.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,737.80 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,737.80 | $1,819.70 | $1,819.70 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $691.83 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,630.27 | $2,691.53 | $2,691.53 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $524.81 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,511.89 | $2,511.89 |
Where Michigan sits
The same service costs 9.8 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 $35,171MD $3,582
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.