How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,148 to $5,495Professionalmedian $1,148 · 10th to 90th $912 to $1,349
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 $1,148.15 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,148.15 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,148.15 | $1,230.27 | $1,230.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $4,073.80 | Facility | None | $2,344.23 | $2,344.23 | $4,073.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $257.04 Median $1,348.96 Typical High $1,348.96 | Professional | None | $257.04 | $1,348.96 | $1,348.96 |
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 $676.08 Median $977.24 Typical High $1,698.24 | Professional | None | $676.08 | $977.24 | $1,698.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $4,897.79 | Facility | None | $2,454.71 | $3,162.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,380.38 | Professional | None | $977.24 | $1,148.15 | $1,380.38 |
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 $676.08 Median $933.25 Typical High $1,380.38 | Professional | None | $676.08 | $933.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,202.26 | Professional | None | $912.01 | $1,023.29 | $1,202.26 |
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 $575.44 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $229.09 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $562.34 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $223.87 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $812.83 |
Where Michigan sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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
OK $11,738KY $2,311
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.