How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,072 to $7,413Professionalmedian $1,096 · 10th to 90th $851 to $1,778
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 $1,071.52 Median $1,096.48 Typical High $6,918.31 | Facility | None | $1,071.52 | $1,096.48 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,071.52 | $1,096.48 | $1,148.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,265.80 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $204.17 Median $1,778.28 Typical High $1,778.28 | Professional | None | $204.17 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $2,818.38 | Professional | None | $630.96 | $977.24 | $2,818.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,096.48 Median $4,897.79 Typical High $6,760.83 | Facility | None | $1,096.48 | $4,897.79 | $6,760.83 |
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 $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,479.11 | Professional | None | $630.96 | $954.99 | $1,479.11 |
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 $870.96 Median $1,000.00 Typical High $1,096.48 | Professional | None | $870.96 | $1,000.00 | $1,096.48 |
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 $537.03 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $776.25 |
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 $537.03 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $831.76 | $831.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $776.25 |
Where Michigan sits
The same service costs 5.3 times more in Colorado than in Montana. 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 $14,031MT $2,667
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.