How much rates vary
Facilitymedian $4,266 · 10th to 90th $501 to $6,761Professionalmedian $1,479 · 10th to 90th $339 to $1,698
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 $1,513.56 Median $1,513.56 Typical High $6,918.31 | Facility | None | $1,513.56 | $1,513.56 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $4,365.16 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,365.16 | $7,413.10 |
BCBS Setting Professional Modifier None Typical Low $288.40 Median $1,047.13 Typical High $1,698.24 | Professional | None | $288.40 | $1,047.13 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,398.83 | Professional | None | $977.24 | $1,348.96 | $2,398.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $4,897.79 | Facility | None | $1,479.11 | $3,467.37 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,479.11 | $1,698.24 |
Priority Health Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,187.76 | Professional | None | $954.99 | $1,288.25 | $2,187.76 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,621.81 | $1,819.70 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
Where Michigan sits
The same service costs 5.6 times more in Alaska 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· 24th of 51
$1,479
AK $4,266TX $759
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.