How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,122 to $6,457Professionalmedian $1,288 · 10th to 90th $275 to $1,514
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 $1,288.25 Median $1,348.96 Typical High $4,897.79 | Facility | None | $1,288.25 | $1,348.96 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,318.26 | $1,380.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $6,165.95 | Facility | None | $3,548.13 | $3,548.13 | $6,165.95 |
BCBS Michigan Setting Professional Modifier None Typical Low $234.42 Median $1,023.29 Typical High $2,089.30 | Professional | None | $234.42 | $1,023.29 | $2,089.30 |
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 $776.25 Median $1,202.26 Typical High $2,137.96 | Professional | None | $776.25 | $1,202.26 | $2,137.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,348.96 Median $2,691.53 Typical High $4,897.79 | Facility | None | $1,348.96 | $2,691.53 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,348.96 | $1,513.56 |
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 $776.25 Median $1,096.48 Typical High $1,698.24 | Professional | None | $776.25 | $1,096.48 | $1,698.24 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $9,120.11 | Facility | None | $851.14 | $2,238.72 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,202.26 | $1,348.96 |
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 $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $933.25 |
Where Michigan sits
The same service costs 4.4 times more in Alaska than in Hawaii. 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 $10,992HI $2,489
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.