How much rates vary
Facilitymedian $2,884 · 10th to 90th $955 to $5,754Professionalmedian $955 · 10th to 90th $646 to $1,549
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 $933.25 Median $954.99 Typical High $6,918.31 | Facility | None | $933.25 | $954.99 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,000.00 | Professional | None | $933.25 | $954.99 | $1,000.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $5,011.87 | Facility | None | $2,884.03 | $2,951.21 | $5,011.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $602.56 Median $1,096.48 Typical High $1,548.82 | Professional | None | $602.56 | $1,096.48 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,071.52 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $4,897.79 | Facility | None | $1,862.09 | $2,691.53 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,071.52 | Professional | None | $758.58 | $954.99 | $1,071.52 |
Priority Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,071.52 | $1,445.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,762.47 | Facility | None | $851.14 | $2,238.72 | $7,762.47 |
United Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,000.00 | Professional | None | $758.58 | $912.01 | $1,000.00 |
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 $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
Where Michigan sits
The same service costs 4.4 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 $9,724MT $2,195
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.