How much rates vary
Facilitymedian $1,698 · 10th to 90th $589 to $3,548Professionalmedian $389 · 10th to 90th $295 to $447
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 $380.19 Median $398.11 Typical High $6,918.31 | Facility | None | $380.19 | $398.11 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $389.05 | Professional | None | $302.00 | $389.05 | $389.05 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $2,951.21 | Facility | None | $1,698.24 | $1,737.80 | $2,951.21 |
BCBS Michigan Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $446.68 | Professional | None | $251.19 | $416.87 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $933.25 | Professional | None | $213.80 | $389.05 | $933.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $389.05 Median $1,479.11 Typical High $6,918.31 | Facility | None | $389.05 | $1,479.11 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $446.68 | Professional | None | $295.12 | $371.54 | $446.68 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $891.25 | Professional | None | $213.80 | $338.84 | $891.25 |
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 $331.13 Median $389.05 Typical High $478.63 | Professional | None | $331.13 | $389.05 | $478.63 |
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 $165.96 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $234.42 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $257.04 |
Where Michigan sits
The same service costs 6.6 times more in Oklahoma than in Montana. 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
OK $6,126MT $925
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.