How much rates vary
Facilitymedian $2,291 · 10th to 90th $794 to $4,898Professionalmedian $646 · 10th to 90th $457 to $741
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 $645.65 Median $2,884.03 Typical High $4,897.79 | Facility | None | $645.65 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | None | $645.65 | $676.08 | $676.08 |
BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,981.07 | Facility | None | $2,290.87 | $2,290.87 | $3,981.07 |
BCBS Setting Professional Modifier None Typical Low $125.89 Median $707.95 Typical High $741.31 | Professional | None | $125.89 | $707.95 | $741.31 |
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 $389.05 Median $602.56 Typical High $891.25 | Professional | None | $389.05 | $602.56 | $891.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $6,918.31 | Facility | None | $1,288.25 | $1,819.70 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $741.31 | Professional | None | $524.81 | $660.69 | $741.31 |
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 $389.05 Median $602.56 Typical High $831.76 | Professional | None | $389.05 | $602.56 | $831.76 |
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 $524.81 Median $616.60 Typical High $676.08 | Professional | None | $524.81 | $616.60 | $676.08 |
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 $323.59 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $489.78 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $467.74 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 50 · Both sides | $794.33 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $478.63 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $67.61 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $467.74 |
Where Michigan sits
The same service costs 6.0 times more in Alaska 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
AK $9,852MT $1,645
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.