How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,047 to $8,913Professionalmedian $813 · 10th to 90th $575 to $1,380
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 $812.83 Median $1,047.13 Typical High $5,754.40 | Facility | None | $812.83 | $1,047.13 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $831.76 | Professional | None | $645.65 | $831.76 | $831.76 |
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 $181.97 Median $977.24 Typical High $1,380.38 | Professional | None | $181.97 | $977.24 | $1,380.38 |
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 $478.63 Median $741.31 Typical High $1,949.84 | Professional | None | $478.63 | $741.31 | $1,949.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,047.13 Median $2,818.38 Typical High $12,589.25 | Facility | None | $1,047.13 | $2,818.38 | $12,589.25 |
Health Alliance Plan Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $891.25 | Professional | None | $630.96 | $794.33 | $891.25 |
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 $478.63 Median $724.44 Typical High $1,122.02 | Professional | None | $478.63 | $724.44 | $1,122.02 |
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 $660.69 Median $758.58 Typical High $851.14 | Professional | None | $660.69 | $758.58 | $851.14 |
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 $398.11 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $588.84 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 50 · Both sides | $1,479.11 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $588.84 |
Where Michigan sits
The same service costs 6.8 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 $13,753MT $2,023
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.