How much rates vary
Facilitymedian $1,950 · 10th to 90th $537 to $3,631Professionalmedian $759 · 10th to 90th $562 to $1,514
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 $794.33 Median $2,041.74 Typical High $4,897.79 | Facility | None | $794.33 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | None | $794.33 | $831.76 | $831.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $199.53 Median $1,071.52 Typical High $1,513.56 | Professional | None | $199.53 | $1,071.52 | $1,513.56 |
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 $489.78 Median $691.83 Typical High $1,174.90 | Professional | None | $489.78 | $691.83 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $1,548.82 Typical High $4,897.79 | Facility | None | $977.24 | $1,548.82 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $851.14 | Professional | None | $588.84 | $758.58 | $851.14 |
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 $489.78 Median $660.69 Typical High $1,174.90 | Professional | None | $489.78 | $660.69 | $1,174.90 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $4,168.69 | Facility | None | $426.58 | $602.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $776.25 | Professional | None | $630.96 | $676.08 | $776.25 |
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 $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 $158.49 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $158.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $602.56 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $123.03 |
Aetna 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 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $616.60 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $575.44 | $588.84 | $588.84 |
Where Michigan sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $6,535DE $1,300
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.