How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,000 to $5,754Professionalmedian $1,950 · 10th to 90th $1,318 to $3,020
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 $1,949.84 Median $2,137.96 Typical High $6,918.31 | Facility | None | $1,949.84 | $2,137.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,949.84 | $2,041.74 | $2,137.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $5,128.61 | Facility | None | $2,951.21 | $2,951.21 | $5,128.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,202.26 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,202.26 | $2,187.76 | $3,019.95 |
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 $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,548.82 | $3,019.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $6,918.31 | Facility | None | $1,905.46 | $2,290.87 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,905.46 | $2,137.96 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $4,466.84 | Professional | None | $1,047.13 | $1,348.96 | $4,466.84 |
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 $1,445.44 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,621.81 | $1,949.84 |
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 $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $977.24 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,479.11 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $295.12 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,412.54 | $1,412.54 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 50 · Both sides | $3,235.94 | $3,235.94 | $3,235.94 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $398.11 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,479.11 | $1,548.82 | $1,548.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $295.12 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $199.53 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,445.44 | $1,445.44 |
Where Michigan sits
The same service costs 3.5 times more in Alaska than in Delaware. 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 $10,952DE $3,164
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.