How much rates vary
Facilitymedian $501 · 10th to 90th $347 to $1,445Professionalmedian $661 · 10th to 90th $501 to $1,202
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 $691.83 Median $4,073.80 Typical High $5,754.40 | Facility | None | $691.83 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | None | $691.83 | $724.44 | $724.44 |
BCBS Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $812.83 | Facility | None | $467.74 | $467.74 | $812.83 |
BCBS Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,202.26 | Professional | None | $501.19 | $794.33 | $1,202.26 |
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 $416.87 Median $630.96 Typical High $870.96 | Professional | None | $416.87 | $630.96 | $870.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $79.43 Median $1,318.26 Typical High $4,897.79 | Facility | None | $79.43 | $1,318.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $724.44 | Professional | None | $501.19 | $645.65 | $724.44 |
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 $416.87 Median $562.34 Typical High $724.44 | Professional | None | $416.87 | $562.34 | $724.44 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $1,995.26 | Facility | None | $288.40 | $426.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $676.08 | Professional | None | $562.34 | $630.96 | $676.08 |
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 $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $524.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $501.19 |
Where Michigan sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 30th of 51
$661
AK $2,239UT $355
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.