How much rates vary
Facilitymedian $14,454 · 10th to 90th $1,259 to $22,387Professionalmedian $617 · 10th to 90th $372 to $741
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 $630.96 Median $4,897.79 Typical High $6,918.31 | Facility | None | $630.96 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $660.69 | Professional | None | $489.78 | $630.96 | $660.69 |
BCBS Michigan Setting Facility Modifier None Typical Low $14,454.40 Median $14,454.40 Typical High $25,118.86 | Facility | None | $14,454.40 | $14,454.40 | $25,118.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $104.71 Median $616.60 Typical High $616.60 | Professional | None | $104.71 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $616.60 Typical High $741.31 | Professional | None | $346.74 | $616.60 | $741.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,230.27 Median $6,918.31 Typical High $9,549.93 | Facility | None | $1,230.27 | $6,918.31 | $9,549.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $724.44 | Professional | None | $489.78 | $602.56 | $724.44 |
Priority Health Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $8,317.64 | Professional | None | $331.13 | $616.60 | $8,317.64 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,570.88 Typical High $16,982.44 | Facility | None | $1,047.13 | $4,570.88 | $16,982.44 |
United Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $812.83 | Professional | None | $562.34 | $691.83 | $812.83 |
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 $257.04 Median $316.23 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $128.82 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $63.10 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $446.68 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $446.68 | $457.09 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | KX · Policy requirements met | $218.78 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $302.00 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $120.23 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $446.68 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $93.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $63.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $436.52 |
Where Michigan sits
The same service costs 16.2 times more in Oklahoma 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
OK $21,968MT $1,353
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.