How much rates vary
Facilitymedian $1,622 · 10th to 90th $851 to $3,890Professionalmedian $912 · 10th to 90th $676 to $1,288
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 $851.14 Median $1,023.29 Typical High $4,897.79 | Facility | None | $851.14 | $1,023.29 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,047.13 | Professional | None | $741.31 | $870.96 | $1,047.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $2,818.38 | Facility | None | $1,621.81 | $1,659.59 | $2,818.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $537.03 Median $912.01 Typical High $1,288.25 | Professional | None | $537.03 | $912.01 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $512.86 Median $741.31 Typical High $1,778.28 | Professional | None | $512.86 | $741.31 | $1,778.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $933.25 Median $1,122.02 Typical High $4,897.79 | Facility | None | $933.25 | $1,122.02 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,071.52 | Professional | None | $794.33 | $912.01 | $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 $467.74 Median $645.65 Typical High $1,412.54 | Professional | None | $467.74 | $645.65 | $1,412.54 |
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 $660.69 Median $812.83 Typical High $1,023.29 | Professional | None | $660.69 | $812.83 | $1,023.29 |
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 $426.58 Median $436.52 Typical High $524.81 | Professional | 52 · Reduced service | $426.58 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $724.44 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,380.38 Typical High $1,949.84 | Professional | 50 · Both sides | $1,380.38 | $1,380.38 | $1,949.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $436.52 Typical High $524.81 | Professional | 52 · Reduced service | $416.87 | $436.52 | $524.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $173.78 | $208.93 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $660.69 | $776.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $154.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $104.71 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $724.44 |
Where Michigan sits
The same service costs 3.7 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 $6,098WV $1,627
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.