How much rates vary
Facilitymedian $2,455 · 10th to 90th $912 to $4,898Professionalmedian $1,122 · 10th to 90th $832 to $1,862
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 $1,148.15 Median $1,174.90 Typical High $6,918.31 | Facility | None | $1,148.15 | $1,174.90 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,148.15 | $1,174.90 | $1,174.90 |
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 $223.87 Median $1,258.93 Typical High $1,995.26 | Professional | None | $223.87 | $1,258.93 | $1,995.26 |
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 $676.08 Median $1,047.13 Typical High $1,584.89 | Professional | None | $676.08 | $1,047.13 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $4,897.79 | Facility | None | $1,621.81 | $1,621.81 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,230.27 | Professional | None | $870.96 | $1,122.02 | $1,230.27 |
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 $676.08 Median $1,000.00 Typical High $1,479.11 | Professional | None | $676.08 | $1,000.00 | $1,479.11 |
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 $933.25 Median $1,023.29 Typical High $1,174.90 | Professional | None | $933.25 | $1,023.29 | $1,174.90 |
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 $575.44 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $575.44 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $114.82 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $831.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $575.44 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $229.09 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $114.82 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $831.76 |
Where Michigan sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.