How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,202 to $13,804Professionalmedian $1,514 · 10th to 90th $977 to $2,344
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 $1,479.11 Median $1,513.56 Typical High $6,918.31 | Facility | None | $1,479.11 | $1,513.56 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,479.11 | $1,513.56 |
BCBS Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $14,454.40 | Facility | None | $8,317.64 | $8,317.64 | $14,454.40 |
BCBS Setting Professional Modifier None Typical Low $263.03 Median $1,548.82 Typical High $2,344.23 | Professional | None | $263.03 | $1,548.82 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,513.56 Typical High $4,073.80 | Professional | None | $831.76 | $1,513.56 | $4,073.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $21,379.62 | Facility | None | $1,513.56 | $3,801.89 | $21,379.62 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,412.54 | $1,905.46 |
Priority Health Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $3,548.13 | Professional | None | $831.76 | $1,479.11 | $3,548.13 |
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 $1,445.44 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,737.80 | $2,137.96 |
13 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 $691.83 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $691.83 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,047.13 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 50 · Both sides | $2,511.89 | $2,511.89 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Where Michigan sits
The same service costs 5.0 times more in Alaska 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
AK $15,182KY $3,040
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.