How much rates vary
Facilitymedian $191 · 10th to 90th $120 to $891Professionalmedian $363 · 10th to 90th $209 to $589
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 $371.54 Median $416.87 Typical High $4,897.79 | Facility | None | $371.54 | $416.87 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $416.87 | Professional | None | $204.17 | $338.84 | $416.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $302.00 | Facility | None | $173.78 | $173.78 | $302.00 |
BCBS Michigan Setting Professional Modifier None Typical Low $77.62 Median $489.78 Typical High $691.83 | Professional | None | $77.62 | $489.78 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $524.81 | Professional | None | $229.09 | $331.13 | $524.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $758.58 Typical High $4,897.79 | Facility | None | $85.11 | $758.58 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $416.87 | Professional | None | $223.87 | $363.08 | $416.87 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $478.63 | Professional | None | $218.78 | $323.59 | $478.63 |
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 $288.40 Median $331.13 Typical High $389.05 | Professional | None | $288.40 | $331.13 | $389.05 |
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 $186.21 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $186.21 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $83.18 | Professional | 53 · Discontinued | $74.13 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $57.54 Typical High $63.10 | Professional | 55 · Aftercare only | $56.23 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $288.40 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | 50 · Both sides | $741.31 | $741.31 | $870.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $190.55 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $190.55 | $204.17 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $74.13 | $75.86 | $83.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $288.40 | $309.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $54.95 | $57.54 | $61.66 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $41.69 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $288.40 |
Where Michigan sits
The same service costs 6.5 times more in Connecticut than in Maryland. 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 $3,149MD $483
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.