How much rates vary
Facilitymedian $129 · 10th to 90th $93 to $617Professionalmedian $132 · 10th to 90th $91 to $234
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 $120.23 Median $165.96 Typical High $4,897.79 | Facility | None | $120.23 | $165.96 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $165.96 | Professional | None | $120.23 | $125.89 | $165.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $169.82 | Facility | None | $93.33 | $93.33 | $169.82 |
BCBS Michigan Setting Professional Modifier None Typical Low $97.72 Median $234.42 Typical High $245.47 | Professional | None | $97.72 | $234.42 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $199.53 | Professional | None | $77.62 | $123.03 | $199.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $173.78 Typical High $2,041.74 | Facility | None | $85.11 | $173.78 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $162.18 | Professional | None | $85.11 | $123.03 | $162.18 |
Priority Health Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $173.78 | Professional | None | $70.79 | $114.82 | $173.78 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $147.91 | Professional | None | $97.72 | $120.23 | $147.91 |
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 $60.26 Median $63.10 Typical High $83.18 | Professional | 52 · Reduced service | $60.26 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $33.11 | Professional | 53 · Discontinued | $23.99 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $93.33 Typical High $123.03 | Professional | 54 · Surgery only | $91.20 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $24.55 | Professional | 55 · Aftercare only | $18.20 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $87.10 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $85.11 | $87.10 | $114.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $61.66 Typical High $81.28 | Professional | 52 · Reduced service | $58.88 | $61.66 | $81.28 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $32.36 | Professional | 53 · Discontinued | $23.99 | $24.55 | $32.36 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $93.33 Typical High $123.03 | Professional | 54 · Surgery only | $89.13 | $93.33 | $123.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.62 Typical High $24.55 | Professional | 55 · Aftercare only | $17.78 | $18.62 | $24.55 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $16.22 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $87.10 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $83.18 | $87.10 | $114.82 |
Where Michigan sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $224
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.