How much rates vary
Facilitymedian $26,303 · 10th to 90th $1,413 to $40,738Professionalmedian $708 · 10th to 90th $245 to $1,096
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 $691.83 Median $933.25 Typical High $4,897.79 | Facility | None | $691.83 | $933.25 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $758.58 | Professional | None | $537.03 | $741.31 | $758.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $26,302.68 Median $26,302.68 Typical High $45,708.82 | Facility | None | $26,302.68 | $26,302.68 | $45,708.82 |
BCBS Michigan Setting Professional Modifier None Typical Low $154.88 Median $741.31 Typical High $1,230.27 | Professional | None | $154.88 | $741.31 | $1,230.27 |
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 $426.58 Median $691.83 Typical High $2,290.87 | Professional | None | $426.58 | $691.83 | $2,290.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $776.25 Median $4,073.80 Typical High $19,952.62 | Facility | None | $776.25 | $4,073.80 | $19,952.62 |
Health Alliance Plan Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $933.25 | Professional | None | $562.34 | $707.95 | $933.25 |
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 $426.58 Median $691.83 Typical High $1,995.26 | Professional | None | $426.58 | $691.83 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $5,248.07 Typical High $20,892.96 | Facility | None | $1,380.38 | $5,248.07 | $20,892.96 |
United Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $891.25 | Professional | None | $588.84 | $676.08 | $891.25 |
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 $288.40 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $436.52 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $407.38 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $70.79 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $501.19 |
Where Michigan sits
The same service costs 24.6 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 $43,875MT $1,787
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.