How much rates vary
Facilitymedian $2,512 · 10th to 90th $794 to $4,898Professionalmedian $661 · 10th to 90th $501 to $1,096
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 $630.96 Median $870.96 Typical High $6,918.31 | Facility | None | $630.96 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $691.83 | Professional | None | $630.96 | $660.69 | $691.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $4,365.16 | Facility | None | $2,511.89 | $2,570.40 | $4,365.16 |
BCBS Michigan Setting Professional Modifier None Typical Low $123.03 Median $776.25 Typical High $1,096.48 | Professional | None | $123.03 | $776.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $1,096.48 | Professional | None | $380.19 | $588.84 | $1,096.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $660.69 Median $1,819.70 Typical High $4,897.79 | Facility | None | $660.69 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $724.44 | Professional | None | $512.86 | $660.69 | $724.44 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $870.96 | Professional | None | $380.19 | $575.44 | $870.96 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $691.83 | Professional | None | $524.81 | $630.96 | $691.83 |
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 $316.23 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $316.23 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $316.23 | $331.13 | $331.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $478.63 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $97.72 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $66.07 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $457.09 |
Where Michigan sits
The same service costs 4.5 times more in Wisconsin 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
WI $7,285MT $1,607
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.