How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,349 to $14,125Professionalmedian $1,514 · 10th to 90th $1,259 to $2,884
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 $1,445.44 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,445.44 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,445.44 | $1,513.56 | $1,513.56 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $15,488.17 | Facility | None | $8,912.51 | $8,912.51 | $15,488.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $331.13 Median $2,238.72 Typical High $2,884.03 | Professional | None | $331.13 | $2,238.72 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $3,162.28 | Professional | None | $870.96 | $1,479.11 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,398.83 Median $3,311.31 Typical High $4,897.79 | Facility | None | $2,398.83 | $3,311.31 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,479.11 | $1,778.28 |
Priority Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,511.89 | Professional | None | $870.96 | $1,479.11 | $2,511.89 |
United Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $10,471.29 | Facility | None | $891.25 | $3,090.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,412.54 | $1,584.89 |
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 $724.44 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,071.52 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | 50 · Both sides | $3,090.30 | $3,090.30 | $3,090.30 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $707.95 | $741.31 | $741.31 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $281.84 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,071.52 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $213.80 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $147.91 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,023.29 | $1,023.29 |
Where Michigan sits
The same service costs 5.0 times more in Colorado than in Kentucky. 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 $14,731KY $2,968
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.