How much rates vary
Facilitymedian $8,318 · 10th to 90th $501 to $12,882Professionalmedian $2,951 · 10th to 90th $1,905 to $3,715
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 $3,090.30 Typical High $6,918.31 | Facility | None | $3,019.95 | $3,090.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $3,090.30 Typical High $3,235.94 | Professional | None | $2,398.83 | $3,090.30 | $3,235.94 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,317.64 Median $8,511.38 Typical High $14,454.40 | Facility | None | $8,317.64 | $8,511.38 | $14,454.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $575.44 Median $1,905.46 Typical High $3,019.95 | Professional | None | $575.44 | $1,905.46 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,951.21 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,951.21 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $7,244.36 | Facility | None | $2,884.03 | $6,606.93 | $7,244.36 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $3,548.13 | Professional | None | $2,454.71 | $2,951.21 | $3,548.13 |
Priority Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,584.89 | $2,187.76 | $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 $2,691.53 Median $3,388.44 Typical High $3,890.45 | Professional | None | $2,691.53 | $3,388.44 | $3,890.45 |
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 $1,548.82 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,202.26 | $1,548.82 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $616.60 Typical High $645.65 | Professional | 53 · Discontinued | $478.63 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,290.87 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,819.70 | $2,290.87 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $457.09 Typical High $478.63 | Professional | 55 · Aftercare only | $363.08 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $309.03 Typical High $323.59 | Professional | 56 · Pre-op care only | $239.88 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,137.96 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,137.96 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,445.44 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $575.44 | $602.56 | $602.56 |
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 $436.52 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $436.52 | $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 7.3 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 $20,260WA $2,785
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.