How much rates vary
Facilitymedian $23,988 · 10th to 90th $1,288 to $37,154Professionalmedian $501 · 10th to 90th $98 to $603
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 $501.19 Median $537.03 Typical High $4,897.79 | Facility | None | $501.19 | $537.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $512.86 | Professional | None | $407.38 | $512.86 | $512.86 |
BCBS Michigan Setting Facility Modifier None Typical Low $23,988.33 Median $24,547.09 Typical High $41,686.94 | Facility | None | $23,988.33 | $24,547.09 | $41,686.94 |
BCBS Michigan Setting Professional Modifier None Typical Low $97.72 Median $549.54 Typical High $616.60 | Professional | None | $97.72 | $549.54 | $616.60 |
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 $302.00 Median $512.86 Typical High $1,288.25 | Professional | None | $302.00 | $512.86 | $1,288.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $537.03 Median $2,884.03 Typical High $19,054.61 | Facility | None | $537.03 | $2,884.03 | $19,054.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $562.34 | Professional | None | $398.11 | $501.19 | $562.34 |
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 $302.00 Median $478.63 Typical High $870.96 | Professional | None | $302.00 | $478.63 | $870.96 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $8,317.64 Typical High $21,379.62 | Facility | None | $1,380.38 | $8,317.64 | $21,379.62 |
United Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $562.34 | Professional | None | $407.38 | $478.63 | $562.34 |
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 $251.19 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $251.19 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $380.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $100.00 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $371.54 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $77.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $363.08 |
Where Michigan sits
The same service costs 29.4 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 $37,066MT $1,262
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.