How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,047 to $12,023Professionalmedian $933 · 10th to 90th $209 to $1,585
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 $933.25 Median $4,073.80 Typical High $5,754.40 | Facility | None | $933.25 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $977.24 | Professional | None | $630.96 | $724.44 | $977.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,585.78 Median $7,762.47 Typical High $13,182.57 | Facility | None | $7,585.78 | $7,762.47 | $13,182.57 |
BCBS Michigan Setting Professional Modifier None Typical Low $177.83 Median $1,122.02 Typical High $1,584.89 | Professional | None | $177.83 | $1,122.02 | $1,584.89 |
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 $575.44 Median $891.25 Typical High $2,511.89 | Professional | None | $575.44 | $891.25 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,949.84 Median $4,897.79 Typical High $5,011.87 | Facility | None | $1,949.84 | $4,897.79 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,047.13 | Professional | None | $630.96 | $912.01 | $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 $575.44 Median $891.25 Typical High $1,288.25 | Professional | None | $575.44 | $891.25 | $1,288.25 |
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 $794.33 Median $912.01 Typical High $1,023.29 | Professional | None | $794.33 | $912.01 | $1,023.29 |
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 $467.74 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $467.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $676.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 50 · Both sides | $1,698.24 | $1,698.24 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $478.63 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $707.95 |
Where Michigan sits
The same service costs 6.0 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 $14,230MT $2,377
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.