How much rates vary
Facilitymedian $1,096 · 10th to 90th $380 to $2,089Professionalmedian $537 · 10th to 90th $398 to $891
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 $588.84 Typical High $4,897.79 | Facility | None | $524.81 | $588.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $588.84 | Professional | None | $446.68 | $537.03 | $588.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,949.84 | Facility | None | $1,096.48 | $1,122.02 | $1,949.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $125.89 Median $812.83 Typical High $954.99 | Professional | None | $125.89 | $812.83 | $954.99 |
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 $338.84 Median $467.74 Typical High $758.58 | Professional | None | $338.84 | $467.74 | $758.58 |
Health Alliance Plan Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,041.74 | Facility | None | $575.44 | $1,148.15 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $602.56 | Professional | None | $426.58 | $537.03 | $602.56 |
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 $309.03 Median $467.74 Typical High $724.44 | Professional | None | $309.03 | $467.74 | $724.44 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,630.27 | Facility | None | $288.40 | $426.58 | $2,630.27 |
United Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $549.54 | Professional | None | $426.58 | $478.63 | $549.54 |
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 $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $407.38 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,000.00 Typical High $1,230.27 | Professional | 50 · Both sides | $1,000.00 | $1,000.00 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $269.15 | $295.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $107.15 | $117.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $407.38 | $436.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $87.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $58.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $407.38 |
Where Michigan sits
The same service costs 4.7 times more in Colorado than in Delaware. 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 $4,364DE $926
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.