How much rates vary
Facilitymedian $2,239 · 10th to 90th $912 to $6,761Professionalmedian $661 · 10th to 90th $372 to $794
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 $660.69 Median $870.96 Typical High $6,918.31 | Facility | None | $660.69 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $741.31 | Professional | None | $537.03 | $707.95 | $741.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $6,918.31 | Facility | None | $2,187.76 | $2,818.38 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $112.20 Median $630.96 Typical High $691.83 | Professional | None | $112.20 | $630.96 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $794.33 | Professional | None | $371.54 | $660.69 | $794.33 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,897.79 | Facility | None | $1,288.25 | $1,288.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $776.25 | Professional | None | $524.81 | $645.65 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $354.81 Median $660.69 Typical High $1,698.24 | Professional | None | $354.81 | $660.69 | $1,698.24 |
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 $588.84 Median $741.31 Typical High $851.14 | Professional | None | $588.84 | $741.31 | $851.14 |
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 $275.42 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $275.42 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $407.38 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $489.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $128.82 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $478.63 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $66.07 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $467.74 |
Where Michigan sits
The same service costs 5.4 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 $7,713MT $1,433
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.