How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,000 to $8,511Professionalmedian $891 · 10th to 90th $617 to $1,479
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 $870.96 Median $933.25 Typical High $4,897.79 | Facility | None | $870.96 | $933.25 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $933.25 | Professional | None | $676.08 | $891.25 | $933.25 |
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 $575.44 Median $977.24 Typical High $1,479.11 | Professional | None | $575.44 | $977.24 | $1,479.11 |
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 $512.86 Median $794.33 Typical High $1,995.26 | Professional | None | $512.86 | $794.33 | $1,995.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $933.25 Median $2,818.38 Typical High $15,135.61 | Facility | None | $933.25 | $2,818.38 | $15,135.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $954.99 | Professional | None | $676.08 | $870.96 | $954.99 |
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 $512.86 Median $794.33 Typical High $1,202.26 | Professional | None | $512.86 | $794.33 | $1,202.26 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $891.25 | Professional | None | $707.95 | $812.83 | $891.25 |
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 $436.52 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $630.96 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 50 · Both sides | $1,584.89 | $1,584.89 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $630.96 |
Where Michigan sits
The same service costs 6.4 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 $13,816MT $2,168
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.