How much rates vary
Facilitymedian $1,660 · 10th to 90th $501 to $3,162Professionalmedian $501 · 10th to 90th $363 to $692
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 $380.19 Median $575.44 Typical High $4,897.79 | Facility | None | $380.19 | $575.44 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | None | $380.19 | $426.58 | $575.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,659.59 | $1,659.59 | $2,884.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $691.83 | Professional | None | $288.40 | $501.19 | $691.83 |
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 $323.59 Median $457.09 Typical High $707.95 | Professional | None | $323.59 | $457.09 | $707.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $501.19 Median $954.99 Typical High $2,884.03 | Facility | None | $501.19 | $954.99 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $660.69 | Professional | None | $380.19 | $537.03 | $660.69 |
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 $302.00 Median $436.52 Typical High $707.95 | Professional | None | $302.00 | $436.52 | $707.95 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,801.89 | Facility | None | $426.58 | $602.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $616.60 | Professional | None | $371.54 | $501.19 | $616.60 |
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 $190.55 Median $213.80 Typical High $288.40 | Professional | 52 · Reduced service | $190.55 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $436.52 | Professional | 54 · Surgery only | $288.40 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $87.10 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $57.54 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $407.38 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $741.31 Typical High $1,174.90 | Professional | 50 · Both sides | $741.31 | $741.31 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $208.93 Typical High $295.12 | Professional | 52 · Reduced service | $190.55 | $208.93 | $295.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $83.18 | $117.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $309.03 Typical High $436.52 | Professional | 54 · Surgery only | $288.40 | $309.03 | $436.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $61.66 Typical High $89.13 | Professional | 55 · Aftercare only | $57.54 | $61.66 | $89.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $41.69 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $41.69 | $58.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $288.40 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $269.15 | $288.40 | $407.38 |
Where Michigan sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.