How much rates vary
Facilitymedian $479 · 10th to 90th $302 to $2,884Professionalmedian $398 · 10th to 90th $209 to $537
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 $436.52 Median $616.60 Typical High $4,897.79 | Facility | None | $436.52 | $616.60 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $436.52 | Professional | None | $331.13 | $436.52 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $524.81 | Facility | None | $302.00 | $309.03 | $524.81 |
BCBS Michigan Setting Professional Modifier None Typical Low $91.20 Median $537.03 Typical High $537.03 | Professional | None | $91.20 | $537.03 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $645.65 | Professional | None | $223.87 | $331.13 | $645.65 |
Health Alliance Plan Setting Facility Modifier None Typical Low $302.00 Median $891.25 Typical High $4,897.79 | Facility | None | $302.00 | $891.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $426.58 | Professional | None | $302.00 | $398.11 | $426.58 |
Priority Health Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $549.54 | Professional | None | $229.09 | $331.13 | $549.54 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $446.68 | Professional | None | $288.40 | $363.08 | $446.68 |
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 $199.53 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $213.80 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $323.59 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $42.66 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $302.00 |
Where Michigan sits
The same service costs 5.5 times more in Colorado than in Michigan. 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 $4,792MI $877
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.