How much rates vary
Facilitymedian $1,660 · 10th to 90th $646 to $3,467Professionalmedian $562 · 10th to 90th $363 to $851
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 $489.78 Median $676.08 Typical High $4,897.79 | Facility | None | $489.78 | $676.08 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $660.69 | Professional | None | $316.23 | $501.19 | $660.69 |
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 $114.82 Median $616.60 Typical High $891.25 | Professional | None | $114.82 | $616.60 | $891.25 |
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 $331.13 Median $524.81 Typical High $977.24 | Professional | None | $331.13 | $524.81 | $977.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,073.80 | Facility | None | $575.44 | $1,174.90 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $724.44 | Professional | None | $380.19 | $537.03 | $724.44 |
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 $295.12 Median $501.19 Typical High $741.31 | Professional | None | $295.12 | $501.19 | $741.31 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $660.69 | Professional | None | $436.52 | $537.03 | $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 $245.47 Median $257.04 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $131.83 | Professional | 53 · Discontinued | $97.72 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $501.19 | Professional | 54 · Surgery only | $371.54 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $66.07 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $467.74 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $912.01 Typical High $1,348.96 | Professional | 50 · Both sides | $912.01 | $912.01 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $257.04 Typical High $346.74 | Professional | 52 · Reduced service | $251.19 | $257.04 | $346.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $138.04 | Professional | 53 · Discontinued | $100.00 | $104.71 | $138.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $524.81 | Professional | 54 · Surgery only | $371.54 | $389.05 | $524.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $104.71 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $104.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $69.18 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $69.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $489.78 |
Where Michigan sits
The same service costs 4.7 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 $6,464MT $1,390
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.