How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,072 to $8,128Professionalmedian $1,698 · 10th to 90th $1,318 to $2,630
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 $1,659.59 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,659.59 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,698.24 | $1,698.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,897.79 Median $5,011.87 Typical High $8,709.64 | Facility | None | $4,897.79 | $5,011.87 | $8,709.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,737.80 | $1,949.84 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $2,238.72 | Professional | None | $977.24 | $1,513.56 | $2,238.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $5,754.40 | Facility | None | $2,691.53 | $3,467.37 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,659.59 | $1,862.09 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,089.30 | Professional | None | $977.24 | $1,479.11 | $2,089.30 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,912.51 | Facility | None | $851.14 | $2,238.72 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,548.82 | $1,737.80 |
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 $812.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,202.26 |
Where Michigan sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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 $14,661HI $3,664
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.