How much rates vary
Facilitymedian $6,457 · 10th to 90th $501 to $10,233Professionalmedian $2,399 · 10th to 90th $1,585 to $3,467
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 $2,398.83 Median $2,454.71 Typical High $6,918.31 | Facility | None | $2,398.83 | $2,454.71 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,454.71 | $2,570.40 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,456.54 Median $6,606.93 Typical High $11,220.18 | Facility | None | $6,456.54 | $6,606.93 | $11,220.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $478.63 Median $2,570.40 Typical High $3,630.78 | Professional | None | $478.63 | $2,570.40 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,380.38 | $2,290.87 | $2,818.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,344.23 Median $5,011.87 Typical High $5,495.41 | Facility | None | $2,344.23 | $5,011.87 | $5,495.41 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,862.09 | $2,290.87 | $2,818.38 |
Priority Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,737.80 | $2,818.38 |
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 $2,089.30 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,089.30 | $2,630.27 | $3,090.30 |
13 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 $977.24 Median $1,230.27 Typical High $1,288.25 | Professional | 52 · Reduced service | $977.24 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $489.78 Typical High $512.86 | Professional | 53 · Discontinued | $389.05 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,862.09 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,445.44 | $1,862.09 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $371.54 Typical High $380.19 | Professional | 55 · Aftercare only | $295.12 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $245.47 Typical High $257.04 | Professional | 56 · Pre-op care only | $194.98 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,737.80 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,737.80 | $1,778.28 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | 50 · Both sides | $3,890.45 | $3,890.45 | $3,890.45 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,174.90 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $467.74 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,737.80 | $1,819.70 | $1,819.70 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $234.42 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,698.24 | $1,698.24 |
Where Michigan sits
The same service costs 7.9 times more in Alabama 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
AL $19,273WA $2,428
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.