How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,230 to $7,586Professionalmedian $1,905 · 10th to 90th $1,380 to $2,884
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 $1,737.80 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,737.80 | $1,995.26 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,905.46 | $1,995.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,168.69 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,318.26 | $2,137.96 | $3,162.28 |
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 $1,122.02 Median $1,949.84 Typical High $4,466.84 | Professional | None | $1,122.02 | $1,949.84 | $4,466.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,905.46 Median $3,801.89 Typical High $9,549.93 | Facility | None | $1,905.46 | $3,801.89 | $9,549.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,905.46 | $2,187.76 |
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 $1,122.02 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,698.24 | $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 $1,621.81 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,778.28 | $2,398.83 |
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 $831.76 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,230.27 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $165.96 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $891.25 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $354.81 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,318.26 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $263.03 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $177.83 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,348.96 | $1,348.96 |
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 $13,410VT $4,434
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.