How much rates vary
Facilitymedian $2,512 · 10th to 90th $794 to $4,898Professionalmedian $741 · 10th to 90th $575 to $1,230
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 $724.44 Median $4,073.80 Typical High $5,754.40 | Facility | None | $724.44 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | None | $724.44 | $741.31 | $741.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $4,365.16 | Facility | None | $2,511.89 | $2,570.40 | $4,365.16 |
BCBS Michigan Setting Professional Modifier None Typical Low $158.49 Median $891.25 Typical High $1,230.27 | Professional | None | $158.49 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $1,023.29 | Professional | None | $426.58 | $660.69 | $1,023.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,445.44 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $812.83 | Professional | None | $575.44 | $724.44 | $812.83 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $912.01 | Professional | None | $426.58 | $645.65 | $912.01 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $794.33 | Professional | None | $588.84 | $707.95 | $794.33 |
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 $363.08 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $363.08 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $363.08 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $144.54 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $112.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $74.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $524.81 |
Where Michigan sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.