How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,047 to $9,120Professionalmedian $1,096 · 10th to 90th $851 to $1,698
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 $1,000.00 Median $1,122.02 Typical High $6,918.31 | Facility | None | $1,000.00 | $1,122.02 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,096.48 | $1,148.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $9,332.54 | Facility | None | $5,370.32 | $5,495.41 | $9,332.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,258.93 | $1,778.28 |
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 $630.96 Median $977.24 Typical High $2,754.23 | Professional | None | $630.96 | $977.24 | $2,754.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,122.02 Median $2,691.53 Typical High $8,128.31 | Facility | None | $1,122.02 | $2,691.53 | $8,128.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,202.26 | Professional | None | $851.14 | $1,096.48 | $1,202.26 |
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 $630.96 Median $977.24 Typical High $1,445.44 | Professional | None | $630.96 | $977.24 | $1,445.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $8,912.51 | Facility | None | $851.14 | $2,290.87 | $8,912.51 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,148.15 | Professional | None | $870.96 | $1,000.00 | $1,148.15 |
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 $524.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $758.58 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 50 · Both sides | $1,905.46 | $1,905.46 | $1,905.46 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $758.58 |
Where Michigan sits
The same service costs 5.9 times more in Colorado than in West Virginia. 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 $14,031WV $2,390
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.