How much rates vary
Facilitymedian $813 · 10th to 90th $120 to $1,660Professionalmedian $575 · 10th to 90th $447 to $977
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 $549.54 Median $630.96 Typical High $4,897.79 | Facility | None | $549.54 | $630.96 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $630.96 | Professional | None | $549.54 | $602.56 | $630.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $1,412.54 | Facility | None | $812.83 | $831.76 | $1,412.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $977.24 | Professional | None | $691.83 | $933.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $776.25 | Professional | None | $354.81 | $501.19 | $776.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $1,122.02 Typical High $4,897.79 | Facility | None | $85.11 | $1,122.02 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $630.96 | Professional | None | $446.68 | $588.84 | $630.96 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $776.25 | Professional | None | $323.59 | $478.63 | $776.25 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,513.56 | Facility | None | $91.20 | $177.83 | $1,513.56 |
United Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $575.44 | Professional | None | $436.52 | $478.63 | $575.44 |
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 $275.42 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $389.05 | $398.11 | $436.52 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | 50 · Both sides | $1,047.13 | $1,288.25 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $281.84 | $309.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $112.20 | $123.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $426.58 | $467.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $93.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $61.66 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $398.11 | $436.52 |
Where Michigan sits
The same service costs 5.3 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 $4,377FL $831
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.