How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $2,754Professionalmedian $676 · 10th to 90th $457 to $1,148
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 $741.31 Typical High $4,897.79 | Facility | None | $676.08 | $741.31 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $741.31 | Professional | None | $537.03 | $707.95 | $741.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $2,290.87 | Facility | None | $1,318.26 | $1,348.96 | $2,290.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $128.82 Median $812.83 Typical High $1,148.15 | Professional | None | $128.82 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $912.01 | Professional | None | $398.11 | $630.96 | $912.01 |
Health Alliance Plan Setting Facility Modifier None Typical Low $707.95 Median $1,318.26 Typical High $4,073.80 | Facility | None | $707.95 | $1,318.26 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $758.58 | Professional | None | $537.03 | $676.08 | $758.58 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $870.96 | Professional | None | $398.11 | $616.60 | $870.96 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $691.83 | Professional | None | $549.54 | $588.84 | $691.83 |
12 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 $338.84 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $134.90 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $501.19 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $69.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $489.78 |
Where Michigan sits
The same service costs 4.0 times more in Colorado than in Maryland. 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 $5,106MD $1,261
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.