How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,349 to $6,457Professionalmedian $1,622 · 10th to 90th $501 to $2,291
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 $512.86 Median $2,089.30 Typical High $4,897.79 | Facility | None | $512.86 | $2,089.30 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $1,548.82 Typical High $2,137.96 | Professional | None | $512.86 | $1,548.82 | $2,137.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $6,456.54 | Facility | None | $2,238.72 | $2,511.89 | $6,456.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $107.15 Median $562.34 Typical High $562.34 | Professional | None | $107.15 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $1,318.26 Typical High $2,511.89 | Professional | None | $338.84 | $1,318.26 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $4,897.79 | Facility | None | $549.54 | $2,238.72 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $1,949.84 Typical High $2,290.87 | Professional | None | $537.03 | $1,949.84 | $2,290.87 |
Priority Health Setting Professional Modifier None Typical Low $323.59 Median $1,318.26 Typical High $2,398.83 | Professional | None | $323.59 | $1,318.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,290.87 | Professional | None | $478.63 | $1,513.56 | $2,290.87 |
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 $257.04 Median $776.25 Typical High $1,071.52 | Professional | 52 · Reduced service | $257.04 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $309.03 Typical High $426.58 | Professional | 53 · Discontinued | $102.33 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $1,174.90 Typical High $1,584.89 | Professional | 54 · Surgery only | $389.05 | $1,174.90 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $234.42 Typical High $323.59 | Professional | 55 · Aftercare only | $77.62 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $154.88 Typical High $213.80 | Professional | 56 · Pre-op care only | $51.29 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $1,096.48 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $363.08 | $1,096.48 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $416.87 Typical High $1,148.15 | Professional | 52 · Reduced service | $257.04 | $416.87 | $1,148.15 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $165.96 Typical High $467.74 | Professional | 53 · Discontinued | $104.71 | $165.96 | $467.74 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $630.96 Typical High $1,737.80 | Professional | 54 · Surgery only | $389.05 | $630.96 | $1,737.80 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $125.89 Typical High $346.74 | Professional | 55 · Aftercare only | $77.62 | $125.89 | $346.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $83.18 Typical High $229.09 | Professional | 56 · Pre-op care only | $52.48 | $83.18 | $229.09 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $588.84 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $363.08 | $588.84 | $1,621.81 |
Where Michigan sits
The same service costs 4.4 times more in Oklahoma than in Maryland. 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 $10,373MD $2,367
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.