How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,023 to $5,754Professionalmedian $1,023 · 10th to 90th $794 to $1,660
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 $977.24 Median $4,073.80 Typical High $5,754.40 | Facility | None | $977.24 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | None | $977.24 | $1,023.29 | $1,023.29 |
BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $5,011.87 | Facility | None | $2,884.03 | $2,951.21 | $5,011.87 |
BCBS Setting Professional Modifier None Typical Low $223.87 Median $1,122.02 Typical High $1,659.59 | Professional | None | $223.87 | $1,122.02 | $1,659.59 |
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 $588.84 Median $912.01 Typical High $1,445.44 | Professional | None | $588.84 | $912.01 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $4,897.79 | Facility | None | $1,995.26 | $2,691.53 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,122.02 | Professional | None | $794.33 | $1,000.00 | $1,122.02 |
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 $588.84 Median $891.25 Typical High $1,348.96 | Professional | None | $588.84 | $891.25 | $1,348.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,762.47 | Facility | None | $851.14 | $2,238.72 | $7,762.47 |
United Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,071.52 | Professional | None | $812.83 | $977.24 | $1,071.52 |
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 $489.78 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $741.31 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $707.95 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,778.28 Typical High $1,778.28 | Professional | 50 · Both sides | $1,513.56 | $1,778.28 | $1,778.28 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $741.31 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $707.95 |
Where Michigan sits
The same service costs 8.3 times more in Alaska than in Texas. 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.
Michigan· 32nd of 51
$1,023
AK $3,162TX $380
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.