How much rates vary
Facilitymedian $4,074 · 10th to 90th $794 to $10,471Professionalmedian $724 · 10th to 90th $251 to $1,072
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 $691.83 Median $758.58 Typical High $4,897.79 | Facility | None | $691.83 | $758.58 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $758.58 | Professional | None | $562.34 | $724.44 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $537.03 Typical High $537.03 | Professional | None | $251.19 | $537.03 | $537.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,073.80 Median $5,248.07 Typical High $12,589.25 | Facility | None | $4,073.80 | $5,248.07 | $12,589.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $120.23 Median $1,000.00 Typical High $1,412.54 | Professional | None | $120.23 | $1,000.00 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $1,445.44 | Professional | None | $416.87 | $676.08 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $741.31 Median $1,778.28 Typical High $6,918.31 | Facility | None | $741.31 | $1,778.28 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $831.76 | Professional | None | $588.84 | $724.44 | $831.76 |
Priority Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Priority Health Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $977.24 | Professional | None | $416.87 | $660.69 | $977.24 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $776.25 | Professional | None | $602.56 | $691.83 | $776.25 |
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 $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $501.19 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,513.56 Typical High $2,398.83 | Professional | 50 · Both sides | $1,513.56 | $1,513.56 | $2,398.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $501.19 |
Where Michigan sits
The same service costs 4.7 times more in Connecticut 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
CT $8,304MT $1,762
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.