How much rates vary
Facilitymedian $1,622 · 10th to 90th $759 to $3,890Professionalmedian $646 · 10th to 90th $490 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 $588.84 Median $776.25 Typical High $5,754.40 | Facility | None | $588.84 | $776.25 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $831.76 | Professional | None | $588.84 | $645.65 | $831.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $2,818.38 | Facility | None | $1,621.81 | $1,659.59 | $2,818.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $102.33 Median $851.14 Typical High $977.24 | Professional | None | $102.33 | $851.14 | $977.24 |
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 $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $1,318.26 | Professional | None | $354.81 | $549.54 | $1,318.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $4,897.79 | Facility | None | $758.58 | $1,445.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $831.76 | Professional | None | $588.84 | $676.08 | $831.76 |
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 $323.59 Median $489.78 Typical High $1,071.52 | Professional | None | $323.59 | $489.78 | $1,071.52 |
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 $467.74 Median $588.84 Typical High $741.31 | Professional | None | $467.74 | $588.84 | $741.31 |
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 $295.12 Median $309.03 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $158.49 | Professional | 53 · Discontinued | $117.49 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $457.09 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $91.20 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $426.58 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $426.58 | $549.54 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | 50 · Both sides | $977.24 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $302.00 Typical High $389.05 | Professional | 52 · Reduced service | $288.40 | $302.00 | $389.05 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $158.49 | Professional | 53 · Discontinued | $117.49 | $120.23 | $158.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $588.84 | Professional | 54 · Surgery only | $436.52 | $457.09 | $588.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $117.49 | Professional | 55 · Aftercare only | $87.10 | $91.20 | $117.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $77.62 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $426.58 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $407.38 | $426.58 | $549.54 |
Where Michigan sits
The same service costs 4.0 times more in Oklahoma than in West Virginia. 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 $5,056WV $1,262
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.