How much rates vary
Facilitymedian $2,291 · 10th to 90th $794 to $6,918Professionalmedian $692 · 10th to 90th $537 to $1,175
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 $676.08 Median $707.95 Typical High $4,897.79 | Facility | None | $676.08 | $707.95 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | None | $537.03 | $691.83 | $691.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $7,079.46 | Facility | None | $2,290.87 | $2,884.03 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $154.88 Median $1,122.02 Typical High $1,174.90 | Professional | None | $154.88 | $1,122.02 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,445.44 | Professional | None | $407.38 | $630.96 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $707.95 Median $1,778.28 Typical High $5,011.87 | Facility | None | $707.95 | $1,778.28 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $776.25 | Professional | None | $549.54 | $676.08 | $776.25 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $954.99 | Professional | None | $407.38 | $616.60 | $954.99 |
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 $562.34 Median $630.96 Typical High $707.95 | Professional | None | $562.34 | $630.96 | $707.95 |
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 $331.13 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $489.78 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 50 · Both sides | $1,258.93 | $1,258.93 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $134.90 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $70.79 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $489.78 |
Where Michigan sits
The same service costs 4.5 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 $7,632MT $1,703
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.