How much rates vary
Facilitymedian $251 · 10th to 90th $141 to $724Professionalmedian $324 · 10th to 90th $200 to $513
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 $346.74 Median $380.19 Typical High $501.19 | Facility | None | $346.74 | $380.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $389.05 | Professional | None | $186.21 | $288.40 | $389.05 |
BCBS Michigan Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $316.23 | Facility | None | $169.82 | $169.82 | $316.23 |
BCBS Michigan Setting Professional Modifier None Typical Low $95.50 Median $512.86 Typical High $707.95 | Professional | None | $95.50 | $512.86 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $537.03 | Professional | None | $208.93 | $309.03 | $537.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $169.82 Median $416.87 Typical High $794.33 | Facility | None | $169.82 | $416.87 | $794.33 |
Health Alliance Plan Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $389.05 | Professional | None | $199.53 | $338.84 | $389.05 |
Priority Health Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $426.58 | Professional | None | $204.17 | $295.12 | $426.58 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $346.74 | Professional | None | $257.04 | $295.12 | $346.74 |
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 $173.78 Median $181.97 Typical High $194.98 | Professional | 52 · Reduced service | $173.78 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $69.18 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $263.03 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $245.47 | $251.19 | $275.42 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $263.03 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $177.83 | $194.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $70.79 | $77.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $257.04 | $263.03 | $288.40 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $57.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $38.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $239.88 | $245.47 | $269.15 |
Where Michigan sits
The same service costs 6.4 times more in Colorado than in Florida. 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 $2,602FL $408
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.