How much rates vary
Facilitymedian $1,738 · 10th to 90th $550 to $3,715Professionalmedian $646 · 10th to 90th $132 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 $645.65 Median $4,073.80 Typical High $5,754.40 | Facility | None | $645.65 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,737.80 | $1,778.28 | $3,090.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $117.49 Median $426.58 Typical High $691.83 | Professional | None | $117.49 | $426.58 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $1,000.00 | Professional | None | $416.87 | $588.84 | $1,000.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $1,380.38 Typical High $4,897.79 | Facility | None | $954.99 | $1,380.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $741.31 | Professional | None | $524.81 | $645.65 | $741.31 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $954.99 | Professional | None | $389.05 | $575.44 | $954.99 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $4,265.80 | Facility | None | $426.58 | $602.56 | $4,265.80 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $794.33 | Professional | None | $575.44 | $741.31 | $794.33 |
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 $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $457.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Where Michigan sits
The same service costs 3.9 times more in Colorado than in Delaware. 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
CO $5,057DE $1,284
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.