How much rates vary
Facilitymedian $1,660 · 10th to 90th $891 to $3,715Professionalmedian $955 · 10th to 90th $646 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 $954.99 Median $4,073.80 Typical High $5,754.40 | Facility | None | $954.99 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | None | $776.25 | $977.24 | $977.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $2,951.21 | Facility | None | $1,659.59 | $1,698.24 | $2,951.21 |
BCBS Michigan Setting Professional Modifier None Typical Low $177.83 Median $1,258.93 Typical High $1,548.82 | Professional | None | $177.83 | $1,258.93 | $1,548.82 |
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 $549.54 Median $870.96 Typical High $1,513.56 | Professional | None | $549.54 | $870.96 | $1,513.56 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $4,897.79 | Facility | None | $1,071.52 | $1,995.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,071.52 | Professional | None | $758.58 | $954.99 | $1,071.52 |
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 $549.54 Median $794.33 Typical High $1,174.90 | Professional | None | $549.54 | $794.33 | $1,174.90 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $954.99 | Professional | None | $758.58 | $851.14 | $954.99 |
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 $478.63 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $467.74 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $186.21 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
Where Michigan sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.