How much rates vary
Facilitymedian $2,512 · 10th to 90th $832 to $4,898Professionalmedian $851 · 10th to 90th $575 to $1,148
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 $891.25 Typical High $4,897.79 | Facility | None | $831.76 | $891.25 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $870.96 | Professional | None | $575.44 | $645.65 | $870.96 |
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 $588.84 Median $1,000.00 Typical High $1,412.54 | Professional | None | $588.84 | $1,000.00 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $1,445.44 | Professional | None | $489.78 | $794.33 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $478.63 Median $1,819.70 Typical High $4,073.80 | Facility | None | $478.63 | $1,819.70 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $912.01 | Professional | None | $588.84 | $812.83 | $912.01 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $1,148.15 | Professional | None | $489.78 | $794.33 | $1,148.15 |
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 $707.95 Median $831.76 Typical High $912.01 | Professional | None | $707.95 | $831.76 | $912.01 |
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 $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $169.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $630.96 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $602.56 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 50 · Both sides | $1,513.56 | $1,513.56 | $1,513.56 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $630.96 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $602.56 |
Where Michigan sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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 $7,283HI $2,091
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.