How much rates vary
Facilitymedian $3,802 · 10th to 90th $912 to $6,607Professionalmedian $1,000 · 10th to 90th $676 to $1,175
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 $1,000.00 Median $1,023.29 Typical High $4,897.79 | Facility | None | $1,000.00 | $1,023.29 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,047.13 | Professional | None | $977.24 | $977.24 | $1,047.13 |
BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Setting Professional Modifier None Typical Low $229.09 Median $707.95 Typical High $1,122.02 | Professional | None | $229.09 | $707.95 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,584.89 | Professional | None | $630.96 | $891.25 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,023.29 | $2,187.76 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,148.15 | Professional | None | $812.83 | $1,000.00 | $1,148.15 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,412.54 | Professional | None | $616.60 | $870.96 | $1,412.54 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,025.60 | Facility | None | $602.56 | $1,230.27 | $6,025.60 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,258.93 | Professional | None | $912.01 | $1,122.02 | $1,258.93 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Michigan sits
The same service costs 4.0 times more in Alaska than in Delaware. 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 $9,177DE $2,272
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.