How much rates vary
Facilitymedian $1,660 · 10th to 90th $550 to $3,388Professionalmedian $724 · 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 $707.95 Median $741.31 Typical High $4,897.79 | Facility | None | $707.95 | $741.31 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $724.44 | Professional | None | $562.34 | $724.44 | $724.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,659.59 | $1,659.59 | $2,884.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $162.18 Median $870.96 Typical High $1,202.26 | Professional | None | $162.18 | $870.96 | $1,202.26 |
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 $416.87 Median $645.65 Typical High $1,096.48 | Professional | None | $416.87 | $645.65 | $1,096.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $724.44 Median $1,380.38 Typical High $4,897.79 | Facility | None | $724.44 | $1,380.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $794.33 | Professional | None | $562.34 | $691.83 | $794.33 |
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 $416.87 Median $630.96 Typical High $1,000.00 | Professional | None | $416.87 | $630.96 | $1,000.00 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,801.89 | Facility | None | $426.58 | $602.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $741.31 | Professional | None | $562.34 | $660.69 | $741.31 |
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 $354.81 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $354.81 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $141.25 | $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 $70.79 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $70.79 | $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 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 50 · Both sides | $1,288.25 | $1,288.25 | $1,288.25 |
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 $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $524.81 | $549.54 | $549.54 |
Health Alliance Plan 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 |
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 $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $512.86 |
Where Michigan sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,382DE $1,376
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.