How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,202 to $6,918Professionalmedian $1,318 · 10th to 90th $1,096 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 $1,202.26 Median $1,380.38 Typical High $6,918.31 | Facility | None | $1,202.26 | $1,380.38 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,318.26 | $1,380.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $6,456.54 | Facility | None | $3,715.35 | $3,801.89 | $6,456.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $281.84 Median $2,089.30 Typical High $2,089.30 | Professional | None | $281.84 | $2,089.30 | $2,089.30 |
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 $776.25 Median $1,380.38 Typical High $3,019.95 | Professional | None | $776.25 | $1,380.38 | $3,019.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $9,120.11 | Facility | None | $1,318.26 | $2,884.03 | $9,120.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,318.26 | $1,584.89 |
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 $776.25 Median $1,202.26 Typical High $2,570.40 | Professional | None | $776.25 | $1,202.26 | $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 $1,174.90 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,288.25 | $1,698.24 |
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 $562.34 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $851.14 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $169.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $794.33 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $602.56 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $245.47 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $912.01 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $120.23 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $912.01 |
Where Michigan sits
The same service costs 3.6 times more in Alaska than in Montana. 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 $11,248MT $3,134
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.