How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,202 to $6,918Professionalmedian $1,738 · 10th to 90th $1,230 to $2,951
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 $1,621.81 Median $1,778.28 Typical High $6,918.31 | Facility | None | $1,621.81 | $1,778.28 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,778.28 | $1,862.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $398.11 Median $2,818.38 Typical High $2,951.21 | Professional | None | $398.11 | $2,818.38 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,819.70 Typical High $4,168.69 | Professional | None | $1,047.13 | $1,819.70 | $4,168.69 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,778.28 Median $3,715.35 Typical High $6,918.31 | Facility | None | $1,778.28 | $3,715.35 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,778.28 | $1,995.26 |
Priority Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Priority Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,584.89 | $2,570.40 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,659.59 | $2,238.72 |
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 $776.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $776.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $309.03 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $154.88 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $812.83 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $331.13 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $245.47 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,258.93 | $1,258.93 |
Where Michigan sits
The same service costs 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.