How much rates vary
Facilitymedian $1,950 · 10th to 90th $501 to $3,631Professionalmedian $427 · 10th to 90th $257 to $692
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 $436.52 Median $501.19 Typical High $4,897.79 | Facility | None | $436.52 | $501.19 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $501.19 | Professional | None | $245.47 | $371.54 | $501.19 |
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 $331.13 Median $562.34 Typical High $794.33 | Professional | None | $331.13 | $562.34 | $794.33 |
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 $281.84 Median $407.38 Typical High $630.96 | Professional | None | $281.84 | $407.38 | $630.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $4,897.79 | Facility | None | $478.63 | $1,071.52 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $501.19 | Professional | None | $257.04 | $416.87 | $501.19 |
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 $257.04 Median $398.11 Typical High $630.96 | Professional | None | $257.04 | $398.11 | $630.96 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $4,168.69 | Facility | None | $426.58 | $602.56 | $4,168.69 |
United Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $457.09 | Professional | None | $346.74 | $389.05 | $457.09 |
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 $218.78 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $218.78 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $331.13 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $309.03 | $316.23 | $354.81 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | 50 · Both sides | $851.14 | $851.14 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $218.78 | $223.87 | $251.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $91.20 | $100.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $323.59 | $338.84 | $380.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $67.61 | $75.86 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $43.65 | $44.67 | $50.12 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $302.00 | $316.23 | $354.81 |
Where Michigan sits
The same service costs 5.6 times more in Colorado than in Delaware. 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 $5,716DE $1,024
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.