How much rates vary
Facilitymedian $6,918 · 10th to 90th $955 to $11,220Professionalmedian $1,047 · 10th to 90th $891 to $1,445
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 $912.01 Median $954.99 Typical High $6,918.31 | Facility | None | $912.01 | $954.99 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | None | $912.01 | $933.25 | $933.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,918.31 Median $7,079.46 Typical High $12,022.64 | Facility | None | $6,918.31 | $7,079.46 | $12,022.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | None | $812.83 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $2,511.89 | Professional | None | $512.86 | $954.99 | $2,511.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $2,570.40 Typical High $6,918.31 | Facility | None | $954.99 | $2,570.40 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,202.26 | Professional | None | $851.14 | $891.25 | $1,202.26 |
Priority Health Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $2,187.76 | Professional | None | $512.86 | $954.99 | $2,187.76 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $9,120.11 | Facility | None | $851.14 | $2,238.72 | $9,120.11 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,445.44 | Professional | None | $977.24 | $1,174.90 | $1,445.44 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $676.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Where Michigan sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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 $14,612KY $2,222
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.