How much rates vary
Facilitymedian $234 · 10th to 90th $120 to $955Professionalmedian $339 · 10th to 90th $240 to $490
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 $295.12 Median $338.84 Typical High $4,897.79 | Facility | None | $295.12 | $338.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $331.13 | Professional | None | $295.12 | $302.00 | $331.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $416.87 | Facility | None | $223.87 | $229.09 | $416.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $67.61 Median $407.38 Typical High $512.86 | Professional | None | $67.61 | $407.38 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $478.63 | Professional | None | $194.98 | $316.23 | $478.63 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $724.44 Typical High $4,897.79 | Facility | None | $85.11 | $724.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $389.05 | Professional | None | $288.40 | $346.74 | $389.05 |
Priority Health Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $398.11 | Professional | None | $194.98 | $288.40 | $398.11 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,513.56 | Facility | None | $91.20 | $177.83 | $1,513.56 |
United Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $380.19 | Professional | None | $281.84 | $323.59 | $380.19 |
12 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 $147.91 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $147.91 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $58.88 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $218.78 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.20 Typical High $33.11 | Professional | 56 · Pre-op care only | $29.51 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $229.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $173.78 | $194.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $66.07 | $69.18 | $77.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $251.19 | $257.04 | $288.40 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $52.48 | $57.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $34.67 | $38.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $239.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $234.42 | $239.88 | $269.15 |
Where Michigan sits
The same service costs 10.5 times more in Colorado than in Florida. 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 $4,157FL $396
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.