How much rates vary
Facilitymedian $2,089 · 10th to 90th $933 to $4,365Professionalmedian $1,585 · 10th to 90th $955 to $2,399
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 $1,548.82 Median $1,584.89 Typical High $6,918.31 | Facility | None | $1,548.82 | $1,584.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,584.89 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $3,630.78 | Facility | None | $2,089.30 | $2,089.30 | $3,630.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $269.15 Median $1,698.24 Typical High $2,398.83 | Professional | None | $269.15 | $1,698.24 | $2,398.83 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,412.54 Typical High $2,344.23 | Professional | None | $851.14 | $1,412.54 | $2,344.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $4,897.79 | Facility | None | $1,445.44 | $1,584.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,621.81 | $2,089.30 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $2,137.96 | Professional | None | $851.14 | $1,148.15 | $2,137.96 |
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 $1,348.96 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,548.82 | $1,905.46 |
13 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 $776.25 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $776.25 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,122.02 | $1,122.02 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 50 · Both sides | $2,570.40 | $2,570.40 | $2,570.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $758.58 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,122.02 | $1,122.02 |
Where Michigan sits
The same service costs 3.2 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 $8,175MD $2,549
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.