How much rates vary
Facilitymedian $4,677 · 10th to 90th $977 to $8,128Professionalmedian $955 · 10th to 90th $617 to $1,549
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 $891.25 Median $977.24 Typical High $5,754.40 | Facility | None | $891.25 | $977.24 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,023.29 | Professional | None | $724.44 | $954.99 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $8,317.64 | Facility | None | $4,677.35 | $4,786.30 | $8,317.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $213.80 Median $1,071.52 Typical High $1,584.89 | Professional | None | $213.80 | $1,071.52 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $2,570.40 | Professional | None | $562.34 | $954.99 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,000.00 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,000.00 | $4,897.79 | $9,120.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,318.26 | Professional | None | $724.44 | $912.01 | $1,318.26 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $2,238.72 | Professional | None | $562.34 | $794.33 | $2,238.72 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,454.71 Typical High $7,943.28 | Facility | None | $851.14 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,174.90 | Professional | None | $831.76 | $954.99 | $1,174.90 |
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 $407.38 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $162.18 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $436.52 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $645.65 |
Where Michigan sits
The same service costs 4.5 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 $10,099MT $2,245
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.