How much rates vary
Facilitymedian $1,950 · 10th to 90th $631 to $3,981Professionalmedian $398 · 10th to 90th $240 to $525
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 $338.84 Median $524.81 Typical High $4,897.79 | Facility | None | $338.84 | $524.81 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $512.86 | Professional | None | $338.84 | $371.54 | $512.86 |
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 $239.88 Typical High $389.05 | Professional | None | $77.62 | $239.88 | $389.05 |
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 $213.80 Median $389.05 Typical High $676.08 | Professional | None | $213.80 | $389.05 | $676.08 |
Health Alliance Plan Setting Facility Modifier None Typical Low $512.86 Median $1,258.93 Typical High $4,897.79 | Facility | None | $512.86 | $1,258.93 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $549.54 | Professional | None | $346.74 | $489.78 | $549.54 |
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 $194.98 Median $338.84 Typical High $575.44 | Professional | None | $194.98 | $338.84 | $575.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $524.81 | Professional | None | $295.12 | $389.05 | $524.81 |
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 $169.82 Median $186.21 Typical High $257.04 | Professional | 52 · Reduced service | $169.82 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $102.33 | Professional | 53 · Discontinued | $67.61 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $251.19 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $77.62 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $363.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 50 · Both sides | $416.87 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $177.83 Typical High $263.03 | Professional | 52 · Reduced service | $165.96 | $177.83 | $263.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $70.79 Typical High $107.15 | Professional | 53 · Discontinued | $66.07 | $70.79 | $107.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $269.15 Typical High $398.11 | Professional | 54 · Surgery only | $251.19 | $269.15 | $398.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $79.43 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $79.43 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $35.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $33.11 | $35.48 | $53.70 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $251.19 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $234.42 | $251.19 | $371.54 |
Where Michigan sits
The same service costs 6.2 times more in Colorado than in Montana. 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 $6,171MT $1,002
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.