How much rates vary
Facilitymedian $708 · 10th to 90th $372 to $2,188Professionalmedian $977 · 10th to 90th $794 to $1,479
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 $1,288.25 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,348.96 | $1,348.96 |
BCBS Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,318.26 | Facility | None | $707.95 | $724.44 | $1,318.26 |
BCBS Setting Professional Modifier None Typical Low $251.19 Median $912.01 Typical High $1,479.11 | Professional | None | $251.19 | $912.01 | $1,479.11 |
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 $691.83 Median $1,023.29 Typical High $1,621.81 | Professional | None | $691.83 | $1,023.29 | $1,621.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $4,897.79 | Facility | None | $512.86 | $2,137.96 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,288.25 | Professional | None | $812.83 | $1,047.13 | $1,288.25 |
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 $794.33 Median $954.99 Typical High $1,348.96 | Professional | None | $794.33 | $954.99 | $1,348.96 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,089.30 | Facility | None | $288.40 | $426.58 | $2,089.30 |
United Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,230.27 | Professional | None | $831.76 | $933.25 | $1,230.27 |
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 $645.65 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $190.55 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $630.96 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $251.19 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $933.25 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $912.01 |
Where Michigan sits
The same service costs 22.4 times more in Alaska than in Texas. 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.
Michigan· 38th of 51
$977
AK $3,981TX $178
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.