How much rates vary
Facilitymedian $2,455 · 10th to 90th $851 to $4,898Professionalmedian $832 · 10th to 90th $562 to $933
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 $831.76 Median $4,073.80 Typical High $5,754.40 | Facility | None | $831.76 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | None | $831.76 | $851.14 | $851.14 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,265.80 | Facility | None | $2,454.71 | $2,454.71 | $4,265.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $186.21 Median $933.25 Typical High $1,318.26 | Professional | None | $186.21 | $933.25 | $1,318.26 |
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 $489.78 Median $758.58 Typical High $1,445.44 | Professional | None | $489.78 | $758.58 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,659.59 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $933.25 | Professional | None | $660.69 | $831.76 | $933.25 |
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 $489.78 Median $758.58 Typical High $1,122.02 | Professional | None | $489.78 | $758.58 | $1,122.02 |
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 $676.08 Median $776.25 Typical High $870.96 | Professional | None | $676.08 | $776.25 | $870.96 |
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 $416.87 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $83.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $602.56 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 50 · Both sides | $1,479.11 | $1,479.11 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $416.87 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $165.96 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $83.18 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $602.56 |
Where Michigan sits
The same service costs 3.7 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 $7,647MT $2,070
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.