How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,413 to $12,882Professionalmedian $1,380 · 10th to 90th $933 to $2,138
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 $1,380.38 Median $1,445.44 Typical High $5,754.40 | Facility | None | $1,380.38 | $1,445.44 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,412.54 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,023.29 | Professional | None | $954.99 | $1,023.29 | $1,023.29 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,495.41 Median $7,079.46 Typical High $16,982.44 | Facility | None | $5,495.41 | $7,079.46 | $16,982.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $302.00 Median $1,513.56 Typical High $2,238.72 | Professional | None | $302.00 | $1,513.56 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,380.38 | Professional | None | $977.24 | $1,023.29 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $3,162.28 | Professional | None | $812.83 | $1,258.93 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,445.44 | $4,570.88 | $9,120.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,412.54 | $1,584.89 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,862.09 | Professional | None | $812.83 | $1,258.93 | $1,862.09 |
United Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $10,232.93 | Facility | None | $891.25 | $3,090.30 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,318.26 | $1,479.11 |
14 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 $676.08 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $676.08 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,000.00 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 50 · Both sides | $2,398.83 | $2,398.83 | $2,398.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $691.83 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $138.04 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $199.53 Typical High $275.42 | Professional | AS · PA/NP assist | $112.20 | $199.53 | $275.42 |
Where Michigan sits
The same service costs 4.2 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 $14,362MT $3,396
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.