How much rates vary
Facilitymedian $13,804 · 10th to 90th $501 to $21,380Professionalmedian $5,129 · 10th to 90th $3,388 to $6,166
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 $4,897.79 Median $5,011.87 Typical High $6,918.31 | Facility | None | $4,897.79 | $5,011.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $5,128.61 Typical High $5,370.32 | Professional | None | $3,981.07 | $5,128.61 | $5,370.32 |
BCBS Michigan Setting Facility Modifier None Typical Low $13,803.84 Median $13,803.84 Typical High $23,988.33 | Facility | None | $13,803.84 | $13,803.84 | $23,988.33 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,023.29 Median $5,128.61 Typical High $7,413.10 | Professional | None | $1,023.29 | $5,128.61 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $4,897.79 Typical High $5,754.40 | Professional | None | $2,818.38 | $4,897.79 | $5,754.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,786.30 Median $10,471.29 Typical High $11,748.98 | Facility | None | $4,786.30 | $10,471.29 | $11,748.98 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,981.07 Median $4,786.30 Typical High $6,025.60 | Professional | None | $3,981.07 | $4,786.30 | $6,025.60 |
Priority Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,630.78 Typical High $5,754.40 | Professional | None | $2,630.27 | $3,630.78 | $5,754.40 |
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 $4,168.69 Median $5,495.41 Typical High $6,456.54 | Professional | None | $4,168.69 | $5,495.41 | $6,456.54 |
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 $1,995.26 Median $2,570.40 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,995.26 | $2,570.40 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,023.29 Typical High $1,071.52 | Professional | 53 · Discontinued | $794.33 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,801.89 Typical High $3,981.07 | Professional | 54 · Surgery only | $3,019.95 | $3,801.89 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $776.25 Typical High $794.33 | Professional | 55 · Aftercare only | $602.56 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $512.86 Typical High $537.03 | Professional | 56 · Pre-op care only | $398.11 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,548.13 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,548.13 | $3,715.35 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2,398.83 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,398.83 | $2,511.89 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $954.99 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,630.78 | $3,715.35 | $3,715.35 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $724.44 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $478.63 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $3,388.44 | $3,467.37 | $3,467.37 |
Where Michigan sits
The same service costs 6.7 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 $26,148WA $3,907
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.