How much rates vary
Facilitymedian $224 · 10th to 90th $120 to $1,288Professionalmedian $661 · 10th to 90th $501 to $1,122
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 $676.08 Typical High $4,897.79 | Facility | None | $645.65 | $676.08 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $707.95 | Professional | None | $645.65 | $660.69 | $707.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $371.54 | Facility | None | $199.53 | $204.17 | $371.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $147.91 Median $794.33 Typical High $1,122.02 | Professional | None | $147.91 | $794.33 | $1,122.02 |
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 $588.84 Typical High $891.25 | Professional | None | $389.05 | $588.84 | $891.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $1,288.25 Typical High $4,897.79 | Facility | None | $85.11 | $1,288.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $707.95 | Professional | None | $512.86 | $660.69 | $707.95 |
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 $380.19 Median $524.81 Typical High $812.83 | Professional | None | $380.19 | $524.81 | $812.83 |
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 $524.81 Median $602.56 Typical High $660.69 | Professional | None | $524.81 | $602.56 | $660.69 |
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 $331.13 Typical High $338.84 | Professional | 52 · Reduced service | $323.59 | $331.13 | $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 $478.63 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $478.63 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $67.61 |
Aetna 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 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,202.26 Typical High $1,348.96 | Professional | 50 · Both sides | $1,202.26 | $1,202.26 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $331.13 Typical High $338.84 | Professional | 52 · Reduced service | $323.59 | $331.13 | $338.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $131.83 | $134.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $501.19 | $512.86 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $102.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $67.61 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $478.63 |
Where Michigan sits
The same service costs 5.2 times more in Connecticut 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
CT $3,486FL $668
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.