How much rates vary
Facilitymedian $741 · 10th to 90th $380 to $2,570Professionalmedian $692 · 10th to 90th $525 to $1,047
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 $676.08 Median $724.44 Typical High $4,073.80 | Facility | None | $676.08 | $724.44 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $758.58 | Professional | None | $602.56 | $707.95 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,288.25 | Facility | None | $741.31 | $741.31 | $1,288.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $169.82 Median $912.01 Typical High $1,288.25 | Professional | None | $169.82 | $912.01 | $1,288.25 |
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 $416.87 Median $616.60 Typical High $954.99 | Professional | None | $416.87 | $616.60 | $954.99 |
Health Alliance Plan Setting Facility Modifier None Typical Low $380.19 Median $912.01 Typical High $3,388.44 | Facility | None | $380.19 | $912.01 | $3,388.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $794.33 | Professional | None | $562.34 | $707.95 | $794.33 |
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 $398.11 Median $602.56 Typical High $851.14 | Professional | None | $398.11 | $602.56 | $851.14 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,630.27 | Facility | None | $288.40 | $426.58 | $2,630.27 |
United Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $724.44 | Professional | None | $562.34 | $660.69 | $724.44 |
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 $331.13 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $478.63 | $512.86 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | 50 · Both sides | $1,348.96 | $1,348.96 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $346.74 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $138.04 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $512.86 | $549.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $109.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $478.63 | $512.86 |
Where Michigan sits
The same service costs 4.0 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 $4,440FL $1,118
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.