How much rates vary
Facilitymedian $3,236 · 10th to 90th $490 to $6,026Professionalmedian $417 · 10th to 90th $288 to $692
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 $407.38 Median $416.87 Typical High $4,897.79 | Facility | None | $407.38 | $416.87 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $478.63 | Professional | None | $316.23 | $407.38 | $478.63 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,754.40 | Facility | None | $3,235.94 | $3,311.31 | $5,754.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $77.62 Median $489.78 Typical High $691.83 | Professional | None | $77.62 | $489.78 | $691.83 |
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 $239.88 Median $426.58 Typical High $1,023.29 | Professional | None | $239.88 | $426.58 | $1,023.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $407.38 Median $1,412.54 Typical High $12,882.50 | Facility | None | $407.38 | $1,412.54 | $12,882.50 |
Health Alliance Plan Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $512.86 | Professional | None | $323.59 | $407.38 | $512.86 |
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 $239.88 Median $371.54 Typical High $891.25 | Professional | None | $239.88 | $371.54 | $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 $363.08 Median $416.87 Typical High $537.03 | Professional | None | $363.08 | $416.87 | $537.03 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $81.28 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $281.84 | $288.40 | $288.40 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 50 · Both sides | $741.31 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $309.03 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $61.66 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $288.40 |
Where Michigan sits
The same service costs 5.1 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 $5,094MT $991
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.