How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,047 to $7,079Professionalmedian $832 · 10th to 90th $676 to $1,202
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 $851.14 Typical High $6,918.31 | Facility | None | $831.76 | $851.14 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $870.96 | Professional | None | $676.08 | $851.14 | $870.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $6,606.93 | Facility | None | $3,715.35 | $3,801.89 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,258.93 | Professional | None | $524.81 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $954.99 | Professional | None | $467.74 | $812.83 | $954.99 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,698.24 | $2,511.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | None | $676.08 | $794.33 | $1,000.00 |
Priority Health Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $954.99 | Professional | None | $436.52 | $602.56 | $954.99 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,549.93 | Facility | None | $891.25 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,071.52 | Professional | None | $741.31 | $933.25 | $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 $331.13 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $169.82 Typical High $177.83 | Professional | 53 · Discontinued | $131.83 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $630.96 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $125.89 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $588.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $467.74 | $588.84 | $616.60 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 50 · Both sides | $1,348.96 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $158.49 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $602.56 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $575.44 |
Where Michigan sits
The same service costs 5.6 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 $10,313MT $1,845
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.