How much rates vary
Facilitymedian $1,950 · 10th to 90th $813 to $4,074Professionalmedian $631 · 10th to 90th $427 to $1,047
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 $616.60 Median $2,884.03 Typical High $4,897.79 | Facility | None | $616.60 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $676.08 | Professional | None | $512.86 | $645.65 | $676.08 |
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 $123.03 Median $724.44 Typical High $1,096.48 | Professional | None | $123.03 | $724.44 | $1,096.48 |
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 $363.08 Median $562.34 Typical High $1,445.44 | Professional | None | $363.08 | $562.34 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $4,897.79 | Facility | None | $1,202.26 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $676.08 | Professional | None | $478.63 | $630.96 | $676.08 |
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 $363.08 Median $562.34 Typical High $870.96 | Professional | None | $363.08 | $562.34 | $870.96 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $630.96 | Professional | None | $501.19 | $562.34 | $630.96 |
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 $309.03 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $446.68 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 50 · Both sides | $1,174.90 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $446.68 |
Where Michigan sits
The same service costs 5.2 times more in Alabama 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
AL $8,325MT $1,589
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.