How much rates vary
Facilitymedian $2,512 · 10th to 90th $955 to $4,898Professionalmedian $1,096 · 10th to 90th $813 to $1,820
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 $1,071.52 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,071.52 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,174.90 | Professional | None | $933.25 | $1,122.02 | $1,174.90 |
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 $218.78 Median $1,288.25 Typical High $1,949.84 | Professional | None | $218.78 | $1,288.25 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,096.48 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,621.81 Median $2,238.72 Typical High $4,897.79 | Facility | None | $1,621.81 | $2,238.72 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,202.26 | Professional | None | $851.14 | $1,096.48 | $1,202.26 |
Priority Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,096.48 | $1,445.44 |
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 $891.25 Median $1,000.00 Typical High $1,122.02 | Professional | None | $891.25 | $1,000.00 | $1,122.02 |
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 $537.03 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $537.03 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $812.83 |
Where Michigan sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.