How much rates vary
Facilitymedian $2,291 · 10th to 90th $794 to $4,677Professionalmedian $589 · 10th to 90th $437 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 $562.34 Median $4,073.80 Typical High $5,754.40 | Facility | None | $562.34 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $616.60 | Professional | None | $478.63 | $588.84 | $616.60 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,981.07 | Facility | None | $2,290.87 | $2,290.87 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $128.82 Median $691.83 Typical High $954.99 | Professional | None | $128.82 | $691.83 | $954.99 |
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 $524.81 Typical High $1,000.00 | Professional | None | $354.81 | $524.81 | $1,000.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,174.90 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $660.69 | Professional | None | $467.74 | $575.44 | $660.69 |
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 $331.13 Median $512.86 Typical High $812.83 | Professional | None | $331.13 | $512.86 | $812.83 |
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 $467.74 Median $562.34 Typical High $676.08 | Professional | None | $467.74 | $562.34 | $676.08 |
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 $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $398.11 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $281.84 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $416.87 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $57.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $389.05 | $407.38 | $407.38 |
Where Michigan sits
The same service costs 5.0 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 $7,200MT $1,432
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.