How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,318 to $7,586Professionalmedian $1,318 · 10th to 90th $832 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 $1,318.26 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,318.26 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,348.96 | $1,380.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $6,918.31 | Facility | None | $3,981.07 | $3,981.07 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $1,995.26 | Professional | None | $831.76 | $1,318.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $1,513.56 | Professional | None | $741.31 | $1,288.25 | $1,513.56 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $9,120.11 | Facility | None | $2,344.23 | $2,884.03 | $9,120.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,258.93 | $1,548.82 |
Priority Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $2,630.27 | Professional | None | $691.83 | $1,288.25 | $2,630.27 |
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 $1,202.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,479.11 | $1,698.24 |
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 $524.81 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $524.81 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $269.15 Typical High $275.42 | Professional | 53 · Discontinued | $208.93 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $776.25 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $199.53 Typical High $208.93 | Professional | 55 · Aftercare only | $154.88 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $134.90 Typical High $138.04 | Professional | 56 · Pre-op care only | $104.71 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $724.44 | $933.25 | $977.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $630.96 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $251.19 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $933.25 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $912.01 |
Where Michigan sits
The same service costs 4.0 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 $11,674MT $2,925
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.