How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,023 to $7,413Professionalmedian $1,202 · 10th to 90th $794 to $1,905
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 $1,202.26 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,202.26 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,230.27 | Professional | None | $977.24 | $1,202.26 | $1,230.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $4,073.80 Typical High $7,079.46 | Facility | None | $3,981.07 | $4,073.80 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $239.88 Median $1,819.70 Typical High $1,905.46 | Professional | None | $239.88 | $1,819.70 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $2,884.03 | Professional | None | $676.08 | $1,071.52 | $2,884.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,344.23 Median $2,454.71 Typical High $5,754.40 | Facility | None | $2,344.23 | $2,454.71 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,445.44 | Professional | None | $933.25 | $1,174.90 | $1,445.44 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,318.26 | Professional | None | $676.08 | $1,071.52 | $1,318.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $9,120.11 | Facility | None | $851.14 | $2,238.72 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,230.27 | $1,548.82 |
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 $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $120.23 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Michigan sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.