How much rates vary
Facilitymedian $4,898 · 10th to 90th $490 to $7,586Professionalmedian $1,862 · 10th to 90th $1,380 to $2,818
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 $1,862.09 Median $1,905.46 Typical High $6,918.31 | Facility | None | $1,862.09 | $1,905.46 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,905.46 | $1,949.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,897.79 Median $5,011.87 Typical High $8,511.38 | Facility | None | $4,897.79 | $5,011.87 | $8,511.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,995.26 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,659.59 | $2,344.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $3,981.07 Typical High $4,897.79 | Facility | None | $1,778.28 | $3,981.07 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,737.80 | $1,949.84 |
Priority Health Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,344.23 | Professional | None | $977.24 | $1,445.44 | $2,344.23 |
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 $1,513.56 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,819.70 | $2,238.72 |
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 $741.31 Median $954.99 Typical High $977.24 | Professional | 52 · Reduced service | $741.31 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $380.19 Typical High $398.11 | Professional | 53 · Discontinued | $295.12 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,412.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,122.02 | $1,412.54 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $281.84 Typical High $295.12 | Professional | 55 · Aftercare only | $223.87 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $190.55 Typical High $194.98 | Professional | 56 · Pre-op care only | $147.91 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,318.26 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,318.26 | $1,380.38 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 50 · Both sides | $3,019.95 | $3,019.95 | $3,019.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $891.25 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,318.26 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,288.25 | $1,288.25 |
Where Michigan sits
The same service costs 9.0 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 $18,428MD $2,041
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.