How much rates vary
Facilitymedian $3,311 · 10th to 90th $759 to $6,457Professionalmedian $708 · 10th to 90th $513 to $912
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 $691.83 Median $758.58 Typical High $5,754.40 | Facility | None | $691.83 | $758.58 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $831.76 | Professional | None | $562.34 | $741.31 | $831.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,311.31 Median $3,388.44 Typical High $5,888.44 | Facility | None | $3,311.31 | $3,388.44 | $5,888.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $144.54 Median $851.14 Typical High $912.01 | Professional | None | $144.54 | $851.14 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,778.28 | Professional | None | $446.68 | $691.83 | $1,778.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $8,709.64 | Facility | None | $741.31 | $3,090.30 | $8,709.64 |
Health Alliance Plan Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $831.76 | Professional | None | $524.81 | $691.83 | $831.76 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,412.54 | Professional | None | $446.68 | $588.84 | $1,412.54 |
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 $575.44 Median $676.08 Typical High $851.14 | Professional | None | $575.44 | $676.08 | $851.14 |
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 $288.40 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $436.52 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $524.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $501.19 |
Where Michigan sits
The same service costs 3.6 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 $6,446MT $1,806
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.