How much rates vary
Facilitymedian $7,079 · 10th to 90th $977 to $11,749Professionalmedian $933 · 10th to 90th $646 to $1,380
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 $912.01 Median $977.24 Typical High $4,897.79 | Facility | None | $912.01 | $977.24 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,000.00 | Professional | None | $724.44 | $933.25 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $12,302.69 | Facility | None | $7,079.46 | $7,079.46 | $12,302.69 |
BCBS Michigan Setting Professional Modifier None Typical Low $204.17 Median $1,023.29 Typical High $1,548.82 | Professional | None | $204.17 | $1,023.29 | $1,548.82 |
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 $549.54 Median $851.14 Typical High $2,398.83 | Professional | None | $549.54 | $851.14 | $2,398.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $4,897.79 Typical High $13,803.84 | Facility | None | $977.24 | $4,897.79 | $13,803.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,047.13 | Professional | None | $741.31 | $933.25 | $1,047.13 |
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 $549.54 Median $831.76 Typical High $1,258.93 | Professional | None | $549.54 | $831.76 | $1,258.93 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $954.99 | Professional | None | $758.58 | $870.96 | $954.99 |
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 $457.09 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $660.69 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 50 · Both sides | $1,659.59 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $660.69 |
Where Michigan sits
The same service costs 6.1 times more in Colorado 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
CO $13,882MT $2,270
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.