How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $3,802Professionalmedian $912 · 10th to 90th $724 to $1,318
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 $776.25 Median $933.25 Typical High $4,897.79 | Facility | None | $776.25 | $933.25 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $977.24 | Professional | None | $691.83 | $812.83 | $977.24 |
BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,862.09 | $1,905.46 | $3,311.31 |
BCBS Setting Professional Modifier None Typical Low $549.54 Median $1,318.26 Typical High $1,318.26 | Professional | None | $549.54 | $1,318.26 | $1,318.26 |
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 $489.78 Median $676.08 Typical High $954.99 | Professional | None | $489.78 | $676.08 | $954.99 |
Health Alliance Plan Setting Facility Modifier None Typical Low $794.33 Median $1,202.26 Typical High $4,897.79 | Facility | None | $794.33 | $1,202.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,096.48 | Professional | None | $758.58 | $912.01 | $1,096.48 |
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 $489.78 Median $724.44 Typical High $954.99 | Professional | None | $489.78 | $724.44 | $954.99 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,311.31 | Facility | None | $426.58 | $602.56 | $3,311.31 |
United Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,047.13 | Professional | None | $724.44 | $851.14 | $1,047.13 |
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 $380.19 Median $389.05 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $645.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $380.19 | $457.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $151.36 | $181.97 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $562.34 | $676.08 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $134.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $91.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $630.96 |
Where Michigan sits
The same service costs 4.5 times more in Alaska than in Texas. 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.
Michigan· 22nd of 51
$912
AK $2,630TX $589
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.