How much rates vary
Facilitymedian $1,995 · 10th to 90th $933 to $4,169Professionalmedian $1,479 · 10th to 90th $1,000 to $1,698
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 $1,412.54 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,412.54 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,513.56 | $1,513.56 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $3,467.37 | Facility | None | $1,995.26 | $2,041.74 | $3,467.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $269.15 Median $1,513.56 Typical High $1,698.24 | Professional | None | $269.15 | $1,513.56 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $3,548.13 | Professional | None | $912.01 | $1,288.25 | $3,548.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $4,897.79 | Facility | None | $1,995.26 | $3,090.30 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,479.11 | $1,778.28 |
Priority Health Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,862.09 | Professional | None | $912.01 | $1,288.25 | $1,862.09 |
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 $1,288.25 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,513.56 | $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 $645.65 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $645.65 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $891.25 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $707.95 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $281.84 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,023.29 |
Where Michigan sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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 $10,675KY $2,405
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.