How much rates vary
Facilitymedian $6,166 · 10th to 90th $501 to $9,772Professionalmedian $2,138 · 10th to 90th $1,349 to $2,455
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 $2,137.96 Median $2,187.76 Typical High $6,918.31 | Facility | None | $2,137.96 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,862.09 | $2,187.76 | $2,187.76 |
BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $6,309.57 Typical High $10,715.19 | Facility | None | $6,165.95 | $6,309.57 | $10,715.19 |
BCBS Setting Professional Modifier None Typical Low $380.19 Median $2,238.72 Typical High $2,238.72 | Professional | None | $380.19 | $2,238.72 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $5,128.61 | Professional | None | $1,202.26 | $1,862.09 | $5,128.61 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,089.30 Median $4,786.30 Typical High $4,897.79 | Facility | None | $2,089.30 | $4,786.30 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,659.59 | $2,089.30 | $2,511.89 |
Priority Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,862.09 | $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 $1,862.09 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,187.76 | $2,754.23 |
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 $933.25 Median $1,071.52 Typical High $1,096.48 | Professional | 52 · Reduced service | $933.25 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $371.54 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,412.54 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $186.21 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,513.56 | $1,513.56 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,548.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,445.44 |
Where Michigan sits
The same service costs 6.8 times more in Alaska than in Texas. 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.
Michigan· 24th of 51
$2,138
AK $6,607TX $977
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.