How much rates vary
Facilitymedian $4,677 · 10th to 90th $912 to $10,471Professionalmedian $912 · 10th to 90th $562 to $1,349
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 $891.25 Median $933.25 Typical High $4,897.79 | Facility | None | $891.25 | $933.25 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $977.24 | Professional | None | $707.95 | $912.01 | $977.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,677.35 Median $6,025.60 Typical High $14,454.40 | Facility | None | $4,677.35 | $6,025.60 | $14,454.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $223.87 Median $1,258.93 Typical High $1,737.80 | Professional | None | $223.87 | $1,258.93 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $891.25 | Professional | None | $645.65 | $660.69 | $891.25 |
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 $524.81 Median $831.76 Typical High $1,445.44 | Professional | None | $524.81 | $831.76 | $1,445.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $7,585.78 | Facility | None | $933.25 | $3,548.13 | $7,585.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,023.29 | Professional | None | $724.44 | $912.01 | $1,023.29 |
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 $524.81 Median $831.76 Typical High $1,202.26 | Professional | None | $524.81 | $831.76 | $1,202.26 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,621.81 Typical High $6,456.54 | Facility | None | $660.69 | $1,621.81 | $6,456.54 |
United Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $933.25 | Professional | None | $724.44 | $851.14 | $933.25 |
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 $446.68 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $645.65 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 50 · Both sides | $1,862.09 | $1,862.09 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $645.65 |
Where Michigan sits
The same service costs 3.6 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 $7,904MT $2,218
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.