How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,000 to $8,318Professionalmedian $1,175 · 10th to 90th $832 to $1,698
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 $1,174.90 Median $1,202.26 Typical High $6,918.31 | Facility | None | $1,174.90 | $1,202.26 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,258.93 | Professional | None | $891.25 | $1,202.26 | $1,258.93 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $8,709.64 | Facility | None | $5,011.87 | $5,011.87 | $8,709.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,290.87 | Professional | None | $741.31 | $1,174.90 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,584.89 | Professional | None | $691.83 | $1,071.52 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $4,897.79 | Facility | None | $2,344.23 | $3,162.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,318.26 | Professional | None | $933.25 | $1,202.26 | $1,318.26 |
Priority Health Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,445.44 | Professional | None | $691.83 | $1,071.52 | $1,445.44 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,230.27 | Professional | None | $954.99 | $1,096.48 | $1,230.27 |
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 $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 50 · Both sides | $2,454.71 | $2,454.71 | $2,454.71 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $870.96 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
Where Michigan sits
The same service costs 6.0 times more in Colorado than in Kentucky. 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 $12,479KY $2,087
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.