How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,148 to $12,589Professionalmedian $1,122 · 10th to 90th $708 to $1,905
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 $1,096.48 Median $1,174.90 Typical High $4,897.79 | Facility | None | $1,096.48 | $1,174.90 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,202.26 | Professional | None | $707.95 | $954.99 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $218.78 Median $1,380.38 Typical High $1,905.46 | Professional | None | $218.78 | $1,380.38 | $1,905.46 |
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 $660.69 Median $1,023.29 Typical High $2,951.21 | Professional | None | $660.69 | $1,023.29 | $2,951.21 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $4,073.80 Typical High $15,135.61 | Facility | None | $1,445.44 | $4,073.80 | $15,135.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,202.26 | Professional | None | $741.31 | $1,096.48 | $1,202.26 |
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 $660.69 Median $977.24 Typical High $1,548.82 | Professional | None | $660.69 | $977.24 | $1,548.82 |
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 $891.25 Median $1,047.13 Typical High $1,148.15 | Professional | None | $891.25 | $1,047.13 | $1,148.15 |
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 $549.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $831.76 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $794.33 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,041.74 Typical High $3,311.31 | Professional | 50 · Both sides | $2,041.74 | $2,041.74 | $3,311.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $562.34 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $223.87 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $812.83 |
Where Michigan sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.