How much rates vary
Facilitymedian $2,512 · 10th to 90th $912 to $4,898Professionalmedian $1,047 · 10th to 90th $234 to $1,660
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 $1,047.13 Median $1,071.52 Typical High $6,918.31 | Facility | None | $1,047.13 | $1,071.52 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | None | $831.76 | $1,071.52 | $1,071.52 |
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 $234.42 Median $1,174.90 Typical High $1,778.28 | Professional | None | $234.42 | $1,174.90 | $1,778.28 |
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 $616.60 Median $954.99 Typical High $1,445.44 | Professional | None | $616.60 | $954.99 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,897.79 | Facility | None | $1,819.70 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,174.90 | Professional | None | $831.76 | $1,047.13 | $1,174.90 |
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 $616.60 Median $891.25 Typical High $1,445.44 | Professional | None | $616.60 | $891.25 | $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 $851.14 Median $977.24 Typical High $1,071.52 | Professional | None | $851.14 | $977.24 | $1,071.52 |
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 $512.86 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $758.58 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 50 · Both sides | $1,905.46 | $1,905.46 | $1,905.46 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $524.81 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $758.58 |
Where Michigan sits
The same service costs 3.1 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 $8,115MD $2,591
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.