How much rates vary
Facilitymedian $1,950 · 10th to 90th $661 to $4,074Professionalmedian $617 · 10th to 90th $427 to $813
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 $426.58 Median $660.69 Typical High $4,897.79 | Facility | None | $426.58 | $660.69 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $660.69 | Professional | None | $426.58 | $512.86 | $660.69 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $100.00 Median $524.81 Typical High $741.31 | Professional | None | $100.00 | $524.81 | $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 $288.40 Median $512.86 Typical High $1,000.00 | Professional | None | $288.40 | $512.86 | $1,000.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $4,897.79 | Facility | None | $676.08 | $1,258.93 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $831.76 | Professional | None | $457.09 | $691.83 | $831.76 |
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 $257.04 Median $489.78 Typical High $870.96 | Professional | None | $257.04 | $489.78 | $870.96 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $794.33 | Professional | None | $416.87 | $562.34 | $794.33 |
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 $213.80 Median $251.19 Typical High $331.13 | Professional | 52 · Reduced service | $213.80 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $87.10 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $371.54 Typical High $489.78 | Professional | 54 · Surgery only | $323.59 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $74.13 Typical High $97.72 | Professional | 55 · Aftercare only | $64.57 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $42.66 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $346.74 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $302.00 | $346.74 | $457.09 |
BCBS Michigan 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 $218.78 Median $245.47 Typical High $346.74 | Professional | 52 · Reduced service | $218.78 | $245.47 | $346.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $138.04 | Professional | 53 · Discontinued | $89.13 | $97.72 | $138.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $524.81 | Professional | 54 · Surgery only | $331.13 | $371.54 | $524.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $104.71 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $104.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $48.98 Typical High $69.18 | Professional | 56 · Pre-op care only | $43.65 | $48.98 | $69.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $489.78 |
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 $6,451MT $1,460
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.