How much rates vary
Facilitymedian $1,862 · 10th to 90th $661 to $3,890Professionalmedian $617 · 10th to 90th $427 to $692
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 $602.56 Median $2,041.74 Typical High $4,897.79 | Facility | None | $602.56 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $616.60 | Professional | None | $537.03 | $616.60 | $616.60 |
BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,862.09 | $1,905.46 | $3,311.31 |
BCBS Setting Professional Modifier None Typical Low $125.89 Median $660.69 Typical High $660.69 | Professional | None | $125.89 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $630.96 Typical High $1,548.82 | Professional | None | $346.74 | $630.96 | $1,548.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $4,897.79 | Facility | None | $1,202.26 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $741.31 | Professional | None | $478.63 | $588.84 | $741.31 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $1,479.11 | Professional | None | $346.74 | $537.03 | $1,479.11 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $776.25 | Professional | None | $537.03 | $645.65 | $776.25 |
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 $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $295.12 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $446.68 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $58.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $416.87 |
Where Michigan sits
The same service costs 4.5 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 $6,608MT $1,483
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.