How much rates vary
Facilitymedian $1,905 · 10th to 90th $724 to $3,890Professionalmedian $575 · 10th to 90th $355 to $871
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 $524.81 Median $741.31 Typical High $4,897.79 | Facility | None | $524.81 | $741.31 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $741.31 | Professional | None | $338.84 | $537.03 | $741.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,905.46 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $120.23 Median $645.65 Typical High $912.01 | Professional | None | $120.23 | $645.65 | $912.01 |
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 $338.84 Median $562.34 Typical High $1,096.48 | Professional | None | $338.84 | $562.34 | $1,096.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $741.31 Median $1,445.44 Typical High $4,897.79 | Facility | None | $741.31 | $1,445.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $776.25 | Professional | None | $407.38 | $575.44 | $776.25 |
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 $316.23 Median $537.03 Typical High $794.33 | Professional | None | $316.23 | $537.03 | $794.33 |
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 $457.09 Median $575.44 Typical High $724.44 | Professional | None | $457.09 | $575.44 | $724.44 |
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 $263.03 Median $275.42 Typical High $371.54 | Professional | 52 · Reduced service | $263.03 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $147.91 | Professional | 53 · Discontinued | $104.71 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $407.38 Typical High $562.34 | Professional | 54 · Surgery only | $398.11 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $112.20 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $74.13 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $380.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $371.54 | $380.19 | $524.81 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 50 · Both sides | $977.24 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $275.42 Typical High $389.05 | Professional | 52 · Reduced service | $263.03 | $275.42 | $389.05 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $154.88 | Professional | 53 · Discontinued | $107.15 | $109.65 | $154.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $575.44 | Professional | 54 · Surgery only | $398.11 | $416.87 | $575.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $114.82 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $114.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $77.62 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $77.62 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $537.03 |
Where Michigan sits
The same service costs 4.4 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 $6,491MT $1,489
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.