How much rates vary
Facilitymedian $501 · 10th to 90th $120 to $1,230Professionalmedian $501 · 10th to 90th $331 to $832
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 $501.19 Median $575.44 Typical High $4,897.79 | Facility | None | $501.19 | $575.44 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $575.44 | Professional | None | $309.03 | $426.58 | $575.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $891.25 | Facility | None | $478.63 | $478.63 | $891.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $398.11 Median $691.83 Typical High $954.99 | Professional | None | $398.11 | $691.83 | $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 $323.59 Median $457.09 Typical High $758.58 | Professional | None | $323.59 | $457.09 | $758.58 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $575.44 Typical High $2,398.83 | Facility | None | $85.11 | $575.44 | $2,398.83 |
Health Alliance Plan Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $575.44 | Professional | None | $331.13 | $501.19 | $575.44 |
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 $295.12 Median $446.68 Typical High $645.65 | Professional | None | $295.12 | $446.68 | $645.65 |
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 $416.87 Median $478.63 Typical High $549.54 | Professional | None | $416.87 | $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 $251.19 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $100.00 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $371.54 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $398.11 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,023.29 Typical High $1,659.59 | Professional | 50 · Both sides | $1,023.29 | $1,023.29 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $257.04 | $281.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $114.82 | Professional | 53 · Discontinued | $100.00 | $102.33 | $114.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $371.54 | $389.05 | $426.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $85.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $57.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $398.11 |
Where Michigan sits
The same service costs 5.6 times more in Connecticut than in Florida. 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 $3,322FL $590
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.