How much rates vary
Facilitymedian $5,370 · 10th to 90th $490 to $8,511Professionalmedian $1,905 · 10th to 90th $1,413 to $3,162
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 $1,862.09 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,862.09 | $1,995.26 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,995.26 | $1,995.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $9,332.54 | Facility | None | $5,370.32 | $5,495.41 | $9,332.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $354.81 Median $3,162.28 Typical High $3,162.28 | Professional | None | $354.81 | $3,162.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,905.46 | $4,168.69 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $4,570.88 Typical High $4,897.79 | Facility | None | $1,819.70 | $4,570.88 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,862.09 | $2,398.83 |
Priority Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,905.46 | $2,344.23 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,778.28 | $2,398.83 |
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 $831.76 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $831.76 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,479.11 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,258.93 | $1,479.11 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $295.12 Typical High $302.00 | Professional | 55 · Aftercare only | $251.19 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,380.38 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,380.38 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $912.01 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $363.08 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,380.38 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $275.42 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $181.97 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,348.96 | $1,348.96 |
Where Michigan sits
The same service costs 7.8 times more in Colorado than in Washington. 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 $16,544WA $2,120
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.