How much rates vary
Facilitymedian $1,479 · 10th to 90th $646 to $3,548Professionalmedian $490 · 10th to 90th $355 to $741
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 $478.63 Median $616.60 Typical High $4,897.79 | Facility | None | $478.63 | $616.60 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $524.81 | Professional | None | $407.38 | $501.19 | $524.81 |
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 $83.18 Median $524.81 Typical High $741.31 | Professional | None | $83.18 | $524.81 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $776.25 | Professional | None | $263.03 | $407.38 | $776.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,897.79 | Facility | None | $524.81 | $1,202.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $537.03 | Professional | None | $380.19 | $489.78 | $537.03 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $954.99 | Professional | None | $251.19 | $346.74 | $954.99 |
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 $371.54 Median $416.87 Typical High $501.19 | Professional | None | $371.54 | $416.87 | $501.19 |
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 $239.88 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $363.08 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $338.84 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $95.50 | $97.72 | $97.72 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $354.81 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $74.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $48.98 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $346.74 |
Where Michigan sits
The same service costs 4.5 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 $4,914MT $1,099
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.