How much rates vary
Facilitymedian $1,950 · 10th to 90th $550 to $3,631Professionalmedian $776 · 10th to 90th $589 to $1,413
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 $776.25 Median $2,041.74 Typical High $4,897.79 | Facility | None | $776.25 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | None | $776.25 | $812.83 | $812.83 |
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 $190.55 Median $1,023.29 Typical High $1,412.54 | Professional | None | $190.55 | $1,023.29 | $1,412.54 |
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 $467.74 Median $691.83 Typical High $1,096.48 | Professional | None | $467.74 | $691.83 | $1,096.48 |
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 $831.76 | Professional | None | $588.84 | $758.58 | $831.76 |
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 $467.74 Median $660.69 Typical High $1,096.48 | Professional | None | $467.74 | $660.69 | $1,096.48 |
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 $616.60 Median $676.08 Typical High $776.25 | Professional | None | $616.60 | $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 $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $562.34 |
Health Alliance Plan 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 |
Health Alliance Plan 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 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $588.84 | $616.60 | $616.60 |
Health Alliance Plan 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 |
Health Alliance Plan 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 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $575.44 |
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 $6,515DE $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.