How much rates vary
Facilitymedian $4,467 · 10th to 90th $501 to $7,079Professionalmedian $1,622 · 10th to 90th $1,096 to $1,778
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 $1,584.89 Median $1,584.89 Typical High $6,918.31 | Facility | None | $1,584.89 | $1,584.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,445.44 | $1,621.81 | $1,621.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,466.84 Median $4,570.88 Typical High $7,943.28 | Facility | None | $4,466.84 | $4,570.88 | $7,943.28 |
BCBS Michigan Setting Professional Modifier None Typical Low $354.81 Median $1,778.28 Typical High $1,778.28 | Professional | None | $354.81 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,380.38 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,548.82 Median $3,630.78 Typical High $4,897.79 | Facility | None | $1,548.82 | $3,630.78 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,548.82 | $1,737.80 |
Priority Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,318.26 | $2,290.87 |
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 $1,380.38 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,698.24 | $1,905.46 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $316.23 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,096.48 |
Where Michigan sits
The same service costs 5.9 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 $10,682MD $1,821
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.