How much rates vary
Facilitymedian $191 · 10th to 90th $120 to $891Professionalmedian $407 · 10th to 90th $257 to $631
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 $398.11 Median $512.86 Typical High $4,897.79 | Facility | None | $398.11 | $512.86 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $446.68 | Professional | None | $338.84 | $407.38 | $446.68 |
BCBS Michigan Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $323.59 | Facility | None | $173.78 | $173.78 | $323.59 |
BCBS Michigan Setting Professional Modifier None Typical Low $83.18 Median $524.81 Typical High $741.31 | Professional | None | $83.18 | $524.81 | $741.31 |
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 $251.19 Median $363.08 Typical High $575.44 | Professional | None | $251.19 | $363.08 | $575.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $512.86 Typical High $2,884.03 | Facility | None | $85.11 | $512.86 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $467.74 | Professional | None | $331.13 | $426.58 | $467.74 |
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 $234.42 Median $346.74 Typical High $512.86 | Professional | None | $234.42 | $346.74 | $512.86 |
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 $323.59 Median $363.08 Typical High $416.87 | Professional | None | $323.59 | $363.08 | $416.87 |
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 $199.53 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $316.23 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 50 · Both sides | $794.33 | $794.33 | $954.99 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $204.17 | $223.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $81.28 | $89.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $295.12 | $309.03 | $331.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $67.61 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $44.67 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $309.03 |
Where Michigan sits
The same service costs 6.3 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 $3,193MD $505
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.