How much rates vary
Facilitymedian $2,754 · 10th to 90th $832 to $5,012Professionalmedian $794 · 10th to 90th $178 to $933
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 $831.76 Median $2,884.03 Typical High $4,897.79 | Facility | None | $831.76 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $851.14 | Professional | None | $724.44 | $831.76 | $851.14 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $4,897.79 | Facility | None | $2,754.23 | $2,818.38 | $4,897.79 |
BCBS Michigan Setting Professional Modifier None Typical Low $177.83 Median $562.34 Typical High $891.25 | Professional | None | $177.83 | $562.34 | $891.25 |
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 $467.74 Median $831.76 Typical High $2,238.72 | Professional | None | $467.74 | $831.76 | $2,238.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,897.79 | Facility | None | $1,174.90 | $1,698.24 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $977.24 | Professional | None | $645.65 | $794.33 | $977.24 |
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 $467.74 Median $741.31 Typical High $1,995.26 | Professional | None | $467.74 | $741.31 | $1,995.26 |
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 $724.44 Median $851.14 Typical High $1,047.13 | Professional | None | $724.44 | $851.14 | $1,047.13 |
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 $363.08 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Michigan sits
The same service costs 4.4 times more in Alabama than in Montana. 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 $8,633MT $1,977
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.