How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,047 to $10,000Professionalmedian $977 · 10th to 90th $759 to $1,549
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 $933.25 Median $977.24 Typical High $6,918.31 | Facility | None | $933.25 | $977.24 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | None | $933.25 | $977.24 | $977.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $10,232.93 | Facility | None | $5,888.44 | $6,025.60 | $10,232.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $208.93 Median $1,047.13 Typical High $1,548.82 | Professional | None | $208.93 | $1,047.13 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $2,511.89 | Professional | None | $562.34 | $870.96 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $5,011.87 | Facility | None | $1,230.27 | $4,570.88 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,071.52 | Professional | None | $758.58 | $933.25 | $1,071.52 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,258.93 | Professional | None | $562.34 | $851.14 | $1,258.93 |
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 $776.25 Median $891.25 Typical High $1,000.00 | Professional | None | $776.25 | $891.25 | $1,000.00 |
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 $467.74 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $467.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $676.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 50 · Both sides | $1,659.59 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $467.74 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $186.21 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $97.72 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $676.08 |
Where Michigan sits
The same service costs 6.2 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 $14,513MT $2,350
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.