How much rates vary
Facilitymedian $3,802 · 10th to 90th $692 to $6,607Professionalmedian $427 · 10th to 90th $331 to $708
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 $416.87 Median $446.68 Typical High $4,897.79 | Facility | None | $416.87 | $446.68 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $446.68 | Professional | None | $323.59 | $416.87 | $446.68 |
BCBS Michigan 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 Michigan Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $707.95 | Professional | None | $467.74 | $501.19 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $1,202.26 | Professional | None | $245.47 | $436.52 | $1,202.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $436.52 Median $1,318.26 Typical High $6,918.31 | Facility | None | $436.52 | $1,318.26 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $512.86 | Professional | None | $331.13 | $416.87 | $512.86 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $1,047.13 | Professional | None | $245.47 | $380.19 | $1,047.13 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $537.03 | Professional | None | $371.54 | $426.58 | $537.03 |
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 $204.17 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $40.74 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $281.84 | $295.12 | $295.12 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 50 · Both sides | $758.58 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $208.93 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $83.18 | $83.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $309.03 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $63.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $41.69 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $288.40 |
Where Michigan sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.