How much rates vary
Facilitymedian $1,950 · 10th to 90th $589 to $4,467Professionalmedian $457 · 10th to 90th $302 to $676
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 $389.05 Median $588.84 Typical High $4,897.79 | Facility | None | $389.05 | $588.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $588.84 | Professional | None | $263.03 | $398.11 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $77.62 Median $489.78 Typical High $776.25 | Professional | None | $77.62 | $489.78 | $776.25 |
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 $257.04 Median $436.52 Typical High $812.83 | Professional | None | $257.04 | $436.52 | $812.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $407.38 Median $1,348.96 Typical High $6,456.54 | Facility | None | $407.38 | $1,348.96 | $6,456.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $616.60 | Professional | None | $302.00 | $457.09 | $616.60 |
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 $229.09 Median $398.11 Typical High $660.69 | Professional | None | $229.09 | $398.11 | $660.69 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $4,570.88 | Facility | None | $602.56 | $1,230.27 | $4,570.88 |
United Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $588.84 | Professional | None | $346.74 | $457.09 | $588.84 |
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 $194.98 Median $208.93 Typical High $288.40 | Professional | 52 · Reduced service | $194.98 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $117.49 | Professional | 53 · Discontinued | $79.43 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $436.52 | Professional | 54 · Surgery only | $295.12 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $87.10 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $407.38 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $724.44 Typical High $1,174.90 | Professional | 50 · Both sides | $724.44 | $724.44 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $204.17 Typical High $302.00 | Professional | 52 · Reduced service | $194.98 | $204.17 | $302.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $120.23 | Professional | 53 · Discontinued | $77.62 | $81.28 | $120.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $446.68 | Professional | 54 · Surgery only | $295.12 | $302.00 | $446.68 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $89.13 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $89.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $60.26 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $281.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $275.42 | $281.84 | $416.87 |
Where Michigan sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $4,833WV $936
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.