How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $2,630Professionalmedian $513 · 10th to 90th $204 to $741
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 $426.58 Median $660.69 Typical High $4,897.79 | Facility | None | $426.58 | $660.69 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $660.69 | Professional | None | $407.38 | $457.09 | $660.69 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,995.26 | Facility | None | $1,122.02 | $1,148.15 | $1,995.26 |
BCBS Michigan Setting Professional Modifier None Typical Low $85.11 Median $537.03 Typical High $741.31 | Professional | None | $85.11 | $537.03 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $831.76 | Professional | None | $257.04 | $446.68 | $831.76 |
Health Alliance Plan Setting Facility Modifier None Typical Low $338.84 Median $660.69 Typical High $3,715.35 | Facility | None | $338.84 | $660.69 | $3,715.35 |
Health Alliance Plan Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $676.08 | Professional | None | $436.52 | $575.44 | $676.08 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $660.69 | Professional | None | $251.19 | $436.52 | $660.69 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $602.56 | Professional | None | $213.80 | $389.05 | $602.56 |
13 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 $208.93 Median $229.09 Typical High $331.13 | Professional | 52 · Reduced service | $208.93 | $229.09 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $131.83 | Professional | 53 · Discontinued | $85.11 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $489.78 | Professional | 54 · Surgery only | $316.23 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $97.72 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $66.07 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $457.09 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 50 · Both sides | $794.33 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $218.78 Typical High $338.84 | Professional | 52 · Reduced service | $208.93 | $218.78 | $338.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $134.90 | Professional | 53 · Discontinued | $83.18 | $87.10 | $134.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $501.19 | Professional | 54 · Surgery only | $316.23 | $323.59 | $501.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $100.00 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $100.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $67.61 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $67.61 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $467.74 |
Where Michigan sits
The same service costs 4.5 times more in Colorado 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
CO $4,866MD $1,088
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.