How much rates vary
Facilitymedian $1,660 · 10th to 90th $550 to $4,074Professionalmedian $813 · 10th to 90th $589 to $1,349
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 $4,073.80 Typical High $5,754.40 | Facility | None | $794.33 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | None | $616.60 | $831.76 | $831.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,659.59 | $1,659.59 | $2,884.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $870.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,122.02 | Professional | None | $478.63 | $707.95 | $1,122.02 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $5,888.44 | Facility | None | $954.99 | $1,819.70 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $891.25 | Professional | None | $630.96 | $794.33 | $891.25 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,122.02 | Professional | None | $478.63 | $645.65 | $1,122.02 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,801.89 | Facility | None | $426.58 | $602.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $812.83 | Professional | None | $549.54 | $676.08 | $812.83 |
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 $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 $588.84 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $588.84 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $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 $549.54 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $575.44 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 50 · Both sides | $1,445.44 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $398.11 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $158.49 | $162.18 | $162.18 |
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 $117.49 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $81.28 |
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 4.6 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 $6,475DE $1,401
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.