How much rates vary
Facilitymedian $813 · 10th to 90th $427 to $2,042Professionalmedian $251 · 10th to 90th $195 to $479
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 $199.53 Median $389.05 Typical High $4,897.79 | Facility | None | $199.53 | $389.05 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $389.05 | Professional | None | $199.53 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $77.62 Typical High $100.00 | Professional | 53 · Discontinued | $39.81 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $147.91 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $43.65 Typical High $57.54 | Professional | 55 · Aftercare only | $29.51 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $28.84 Typical High $38.90 | Professional | 56 · Pre-op care only | $19.95 | $28.84 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $281.84 | Professional | None | $138.04 | $281.84 | $281.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $794.33 Median $812.83 Typical High $1,412.54 | Facility | None | $794.33 | $812.83 | $1,412.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $41.69 Median $218.78 Typical High $234.42 | Professional | None | $41.69 | $218.78 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $512.86 | Professional | None | $158.49 | $288.40 | $512.86 |
Health Alliance Plan Setting Facility Modifier None Typical Low $398.11 Median $1,047.13 Typical High $2,818.38 | Facility | None | $398.11 | $1,047.13 | $2,818.38 |
Health Alliance Plan Setting Professional Modifier None Typical Low $199.53 Median $398.11 Typical High $478.63 | Professional | None | $199.53 | $398.11 | $478.63 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $169.82 Typical High $223.87 | Professional | 53 · Discontinued | $39.81 | $169.82 | $223.87 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $177.83 Typical High $295.12 | Professional | 54 · Surgery only | $147.91 | $177.83 | $295.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $37.15 Typical High $58.88 | Professional | 55 · Aftercare only | $29.51 | $37.15 | $58.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.12 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.95 | $25.12 | $39.81 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $478.63 | Professional | None | $147.91 | $257.04 | $478.63 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,951.21 | Facility | None | $426.58 | $602.56 | $2,951.21 |
United Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $512.86 | Professional | None | $194.98 | $281.84 | $512.86 |
3 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 $100.00 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $100.00 | $100.00 | $125.89 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $125.89 Typical High $199.53 | Professional | 52 · Reduced service | $100.00 | $125.89 | $199.53 |
Where Michigan sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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 $3,190ND $672
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.