How much rates vary
Facilitymedian $1,479 · 10th to 90th $813 to $3,090Professionalmedian $646 · 10th to 90th $389 to $977
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 $562.34 Median $1,148.15 Typical High $4,897.79 | Facility | None | $562.34 | $1,148.15 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $1,148.15 | Professional | None | $562.34 | $602.56 | $1,148.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,570.40 | Facility | None | $1,479.11 | $1,479.11 | $2,570.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $977.24 | Professional | None | $389.05 | $407.38 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $588.84 Typical High $1,348.96 | Professional | None | $275.42 | $588.84 | $1,348.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $4,897.79 | Facility | None | $812.83 | $1,445.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $954.99 | Professional | None | $467.74 | $741.31 | $954.99 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $1,023.29 | Professional | None | $269.15 | $537.03 | $1,023.29 |
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 $389.05 Median $575.44 Typical High $831.76 | Professional | None | $389.05 | $575.44 | $831.76 |
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 $281.84 Median $302.00 Typical High $575.44 | Professional | 52 · Reduced service | $281.84 | $302.00 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $234.42 | Professional | 53 · Discontinued | $112.20 | $120.23 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $870.96 | Professional | 54 · Surgery only | $426.58 | $446.68 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $173.78 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $114.82 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $812.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $275.42 Typical High $416.87 | Professional | 52 · Reduced service | $223.87 | $275.42 | $416.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $169.82 | Professional | 53 · Discontinued | $91.20 | $109.65 | $169.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $416.87 Typical High $630.96 | Professional | 54 · Surgery only | $338.84 | $416.87 | $630.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $125.89 | Professional | 55 · Aftercare only | $67.61 | $83.18 | $125.89 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $85.11 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $85.11 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $389.05 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $316.23 | $389.05 | $588.84 |
Where Michigan sits
The same service costs 3.2 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 $4,968MT $1,567
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.