How much rates vary
Facilitymedian $4,467 · 10th to 90th $955 to $7,762Professionalmedian $1,349 · 10th to 90th $955 to $2,089
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 $1,318.26 Median $1,445.44 Typical High $5,754.40 | Facility | None | $1,318.26 | $1,445.44 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,380.38 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,466.84 Median $4,570.88 Typical High $7,943.28 | Facility | None | $4,466.84 | $4,570.88 | $7,943.28 |
BCBS Michigan Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $2,089.30 | Professional | None | $870.96 | $1,513.56 | $2,089.30 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $707.95 Median $1,096.48 Typical High $2,089.30 | Professional | None | $707.95 | $1,096.48 | $2,089.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,122.02 Median $2,570.40 Typical High $8,128.31 | Facility | None | $1,122.02 | $2,570.40 | $8,128.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Professional | None | $954.99 | $1,230.27 | $1,445.44 |
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 $707.95 Median $954.99 Typical High $3,019.95 | Professional | None | $707.95 | $954.99 | $3,019.95 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,760.83 | Facility | None | $660.69 | $1,548.82 | $6,760.83 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,318.26 | Professional | None | $954.99 | $1,071.52 | $1,318.26 |
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 $660.69 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $954.99 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 50 · Both sides | $2,238.72 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $676.08 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $269.15 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $134.90 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $977.24 |
Where Michigan sits
The same service costs 3.4 times more in Alaska than in West Virginia. 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 $8,636WV $2,535
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.