How much rates vary
Facilitymedian $2,754 · 10th to 90th $794 to $5,012Professionalmedian $513 · 10th to 90th $355 to $794
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 $512.86 Median $4,073.80 Typical High $5,754.40 | Facility | None | $512.86 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $524.81 | Professional | None | $446.68 | $512.86 | $524.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $4,897.79 | Facility | None | $2,754.23 | $2,818.38 | $4,897.79 |
BCBS Michigan Setting Professional Modifier None Typical Low $107.15 Median $537.03 Typical High $794.33 | Professional | None | $107.15 | $537.03 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $1,230.27 | Professional | None | $288.40 | $478.63 | $1,230.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $524.81 Median $1,479.11 Typical High $4,897.79 | Facility | None | $524.81 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $630.96 | Professional | None | $407.38 | $501.19 | $630.96 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $562.34 | Professional | None | $288.40 | $478.63 | $562.34 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $660.69 | Professional | None | $457.09 | $549.54 | $660.69 |
10 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 $223.87 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $51.29 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $51.29 | $52.48 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Where Michigan sits
The same service costs 5.7 times more in Colorado 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
CO $6,741MT $1,191
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.