How much rates vary
Facilitymedian $1,349 · 10th to 90th $891 to $4,571Professionalmedian $427 · 10th to 90th $282 to $501
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 $426.58 Median $4,073.80 Typical High $5,754.40 | Facility | None | $426.58 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $457.09 | Professional | None | $331.13 | $436.52 | $457.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $3,548.13 | Facility | None | $1,148.15 | $1,479.11 | $3,548.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $72.44 Median $426.58 Typical High $426.58 | Professional | None | $72.44 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $512.86 | Professional | None | $239.88 | $407.38 | $512.86 |
Health Alliance Plan Setting Facility Modifier None Typical Low $812.83 Median $1,288.25 Typical High $4,897.79 | Facility | None | $812.83 | $1,288.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $501.19 | Professional | None | $323.59 | $407.38 | $501.19 |
Priority Health Setting Professional Modifier None Typical Low $223.87 Median $407.38 Typical High $1,513.56 | Professional | None | $223.87 | $407.38 | $1,513.56 |
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 $371.54 Median $467.74 Typical High $549.54 | Professional | None | $371.54 | $467.74 | $549.54 |
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 $173.78 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $69.18 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $34.67 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $309.03 | $316.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $309.03 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $42.66 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $295.12 |
Where Michigan sits
The same service costs 8.0 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 $7,419MT $925
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.