How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,349 to $15,136Professionalmedian $5,754 · 10th to 90th $550 to $9,333
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 $602.56 Median $5,754.40 Typical High $6,918.31 | Facility | None | $602.56 | $5,754.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $5,128.61 Typical High $6,918.31 | Professional | None | $602.56 | $5,128.61 | $6,918.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,248.07 Median $6,025.60 Typical High $15,488.17 | Facility | None | $5,248.07 | $6,025.60 | $15,488.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $131.83 Median $660.69 Typical High $9,549.93 | Professional | None | $131.83 | $660.69 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $3,162.28 Typical High $9,772.37 | Professional | None | $398.11 | $3,162.28 | $9,772.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $645.65 Median $4,897.79 Typical High $18,197.01 | Facility | None | $645.65 | $4,897.79 | $18,197.01 |
Health Alliance Plan Setting Professional Modifier None Typical Low $630.96 Median $7,244.36 Typical High $9,120.11 | Professional | None | $630.96 | $7,244.36 | $9,120.11 |
Priority Health Setting Professional Modifier None Typical Low $389.05 Median $3,162.28 Typical High $9,332.54 | Professional | None | $389.05 | $3,162.28 | $9,332.54 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,951.21 Typical High $10,471.29 | Facility | None | $891.25 | $2,951.21 | $10,471.29 |
United Setting Professional Modifier None Typical Low $588.84 Median $5,011.87 Typical High $9,332.54 | Professional | None | $588.84 | $5,011.87 | $9,332.54 |
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 $302.00 Median $2,398.83 Typical High $3,235.94 | Professional | 52 · Reduced service | $302.00 | $2,398.83 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $954.99 Typical High $1,318.26 | Professional | 53 · Discontinued | $120.23 | $954.99 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $3,630.78 Typical High $4,897.79 | Professional | 54 · Surgery only | $457.09 | $3,630.78 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $724.44 Typical High $977.24 | Professional | 55 · Aftercare only | $91.20 | $724.44 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $478.63 Typical High $660.69 | Professional | 56 · Pre-op care only | $60.26 | $478.63 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $3,388.44 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $426.58 | $3,388.44 | $4,570.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $478.63 Typical High $3,630.78 | Professional | 52 · Reduced service | $302.00 | $478.63 | $3,630.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $194.98 Typical High $1,445.44 | Professional | 53 · Discontinued | $123.03 | $194.98 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $724.44 Typical High $5,495.41 | Professional | 54 · Surgery only | $457.09 | $724.44 | $5,495.41 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $1,096.48 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $97.72 Typical High $724.44 | Professional | 56 · Pre-op care only | $60.26 | $97.72 | $724.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $676.08 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $426.58 | $676.08 | $5,128.61 |
Where Michigan sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,466
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.