How much rates vary
Facilitymedian $1,023 · 10th to 90th $550 to $2,884Professionalmedian $661 · 10th to 90th $457 to $912
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 $645.65 Median $741.31 Typical High $4,897.79 | Facility | None | $645.65 | $741.31 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $758.58 | Professional | None | $645.65 | $691.83 | $758.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,778.28 | Facility | None | $1,023.29 | $1,023.29 | $1,778.28 |
BCBS Michigan Setting Professional Modifier None Typical Low $125.89 Median $707.95 Typical High $1,122.02 | Professional | None | $125.89 | $707.95 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $912.01 | Professional | None | $416.87 | $616.60 | $912.01 |
Health Alliance Plan Setting Facility Modifier None Typical Low $660.69 Median $1,513.56 Typical High $4,073.80 | Facility | None | $660.69 | $1,513.56 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $776.25 | Professional | None | $562.34 | $691.83 | $776.25 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $812.83 | Professional | None | $380.19 | $575.44 | $812.83 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $707.95 | Professional | None | $537.03 | $616.60 | $707.95 |
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 $323.59 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $512.86 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,513.56 Typical High $1,513.56 | Professional | 50 · Both sides | $1,174.90 | $1,513.56 | $1,513.56 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $331.13 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $131.83 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $501.19 | $549.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $109.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $512.86 |
Where Michigan sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.