How much rates vary
Facilitymedian $1,660 · 10th to 90th $589 to $3,548Professionalmedian $407 · 10th to 90th $288 to $537
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 $346.74 Median $478.63 Typical High $4,897.79 | Facility | None | $346.74 | $478.63 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $478.63 | Professional | None | $316.23 | $371.54 | $478.63 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,659.59 | $1,659.59 | $2,884.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $512.86 | Professional | None | $186.21 | $309.03 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $457.09 | Professional | None | $239.88 | $323.59 | $457.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $4,897.79 | Facility | None | $446.68 | $1,318.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $549.54 | Professional | None | $338.84 | $478.63 | $549.54 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $457.09 | Professional | None | $239.88 | $323.59 | $457.09 |
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 $323.59 Median $407.38 Typical High $501.19 | Professional | None | $323.59 | $407.38 | $501.19 |
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 $173.78 Median $173.78 Typical High $239.88 | Professional | 52 · Reduced service | $173.78 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $70.79 Typical High $95.50 | Professional | 53 · Discontinued | $69.18 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | 54 · Surgery only | $263.03 | $263.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $47.86 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $338.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $234.42 | Professional | 52 · Reduced service | $169.82 | $169.82 | $234.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $95.50 | Professional | 53 · Discontinued | $69.18 | $69.18 | $95.50 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $257.04 | $257.04 | $354.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $70.79 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $47.86 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $331.13 |
Where Michigan sits
The same service costs 6.1 times more in Colorado 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
CO $6,346MT $1,043
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.