How much rates vary
Facilitymedian $2,291 · 10th to 90th $759 to $4,786Professionalmedian $537 · 10th to 90th $398 to $955
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 $537.03 Median $575.44 Typical High $5,754.40 | Facility | None | $537.03 | $575.44 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $588.84 | Professional | None | $363.08 | $436.52 | $588.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,981.07 | Facility | None | $2,290.87 | $2,290.87 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $398.11 Median $676.08 Typical High $954.99 | Professional | None | $398.11 | $676.08 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $1,096.48 | Professional | None | $316.23 | $512.86 | $1,096.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $575.44 Median $1,949.84 Typical High $5,754.40 | Facility | None | $575.44 | $1,949.84 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $588.84 | Professional | None | $380.19 | $537.03 | $588.84 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $758.58 | Professional | None | $316.23 | $512.86 | $758.58 |
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 $457.09 Median $524.81 Typical High $588.84 | Professional | None | $457.09 | $524.81 | $588.84 |
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 $269.15 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $407.38 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $81.28 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $380.19 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $269.15 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $107.15 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $54.95 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $389.05 |
Where Michigan sits
The same service costs 5.1 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 $7,097MT $1,384
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.