How much rates vary
Facilitymedian $1,862 · 10th to 90th $692 to $3,890Professionalmedian $575 · 10th to 90th $417 to $759
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 $512.86 Median $691.83 Typical High $4,897.79 | Facility | None | $512.86 | $691.83 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $691.83 | Professional | None | $512.86 | $549.54 | $691.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,862.09 | $1,905.46 | $3,311.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $112.20 Median $562.34 Typical High $562.34 | Professional | None | $112.20 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $831.76 | Professional | None | $354.81 | $524.81 | $831.76 |
Health Alliance Plan Setting Facility Modifier None Typical Low $707.95 Median $1,412.54 Typical High $4,897.79 | Facility | None | $707.95 | $1,412.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $741.31 | Professional | None | $512.86 | $645.65 | $741.31 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $758.58 | Professional | None | $354.81 | $512.86 | $758.58 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $812.83 | Professional | None | $457.09 | $616.60 | $812.83 |
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 $257.04 Median $275.42 Typical High $346.74 | Professional | 52 · Reduced service | $257.04 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $138.04 | Professional | 53 · Discontinued | $102.33 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $69.18 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $489.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $257.04 | $275.42 | $354.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $104.71 | $109.65 | $141.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $407.38 | $524.81 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $104.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $70.79 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $489.78 |
Where Michigan sits
The same service costs 4.6 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 $6,614MT $1,440
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.