How much rates vary
Facilitymedian $813 · 10th to 90th $120 to $1,660Professionalmedian $661 · 10th to 90th $537 to $1,000
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 $645.65 Median $724.44 Typical High $4,897.79 | Facility | None | $645.65 | $724.44 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $724.44 | Professional | None | $645.65 | $660.69 | $724.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $1,412.54 | Facility | None | $812.83 | $831.76 | $1,412.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $1,122.02 | Professional | None | $467.74 | $812.83 | $1,122.02 |
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 $588.84 Typical High $912.01 | Professional | None | $416.87 | $588.84 | $912.01 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $1,318.26 Typical High $4,897.79 | Facility | None | $85.11 | $1,318.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $741.31 | Professional | None | $537.03 | $676.08 | $741.31 |
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 $380.19 Median $575.44 Typical High $812.83 | Professional | None | $380.19 | $575.44 | $812.83 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,513.56 | Facility | None | $91.20 | $177.83 | $1,513.56 |
United Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $691.83 | Professional | None | $524.81 | $588.84 | $691.83 |
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 $323.59 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $323.59 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $512.86 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 50 · Both sides | $1,202.26 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $331.13 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $131.83 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $501.19 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $109.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $501.19 |
Where Michigan sits
The same service costs 4.8 times more in Colorado than in Florida. 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 $4,494FL $939
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.