How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,230 to $7,079Professionalmedian $1,380 · 10th to 90th $871 to $1,995
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 $1,380.38 Median $1,412.54 Typical High $6,918.31 | Facility | None | $1,380.38 | $1,412.54 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,412.54 | $1,479.11 |
BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $6,606.93 | Facility | None | $3,715.35 | $3,801.89 | $6,606.93 |
BCBS Setting Professional Modifier None Typical Low $239.88 Median $1,479.11 Typical High $2,089.30 | Professional | None | $239.88 | $1,479.11 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,348.96 Typical High $1,584.89 | Professional | None | $776.25 | $1,348.96 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $4,897.79 | Facility | None | $2,511.89 | $2,511.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,318.26 | $1,621.81 |
Priority Health Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,584.89 | Professional | None | $724.44 | $977.24 | $1,584.89 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,549.93 | Facility | None | $891.25 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,584.89 | $1,819.70 |
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 $549.54 Median $707.95 Typical High $741.31 | Professional | 52 · Reduced service | $549.54 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $281.84 Typical High $295.12 | Professional | 53 · Discontinued | $218.78 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,071.52 Typical High $1,096.48 | Professional | 54 · Surgery only | $831.76 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $213.80 Typical High $218.78 | Professional | 55 · Aftercare only | $165.96 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $141.25 Typical High $147.91 | Professional | 56 · Pre-op care only | $109.65 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,000.00 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $776.25 | $1,000.00 | $1,023.29 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 50 · Both sides | $2,238.72 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $660.69 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $954.99 |
Where Michigan sits
The same service costs 5.0 times more in Wisconsin than in Texas. 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.
Michigan· 36th of 51
$1,479
WI $4,365TX $871
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.