How much rates vary
Facilitymedian $2,188 · 10th to 90th $813 to $4,571Professionalmedian $724 · 10th to 90th $501 to $832
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 $724.44 Median $870.96 Typical High $6,918.31 | Facility | None | $724.44 | $870.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | None | $588.84 | $724.44 | $724.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $3,801.89 | Facility | None | $2,187.76 | $2,238.72 | $3,801.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $162.18 Median $501.19 Typical High $812.83 | Professional | None | $162.18 | $501.19 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $1,819.70 | Professional | None | $416.87 | $758.58 | $1,819.70 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $4,897.79 | Facility | None | $1,318.26 | $1,412.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $870.96 | Professional | None | $575.44 | $724.44 | $870.96 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $1,548.82 | Professional | None | $416.87 | $660.69 | $1,548.82 |
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 $645.65 Median $741.31 Typical High $933.25 | Professional | None | $645.65 | $741.31 | $933.25 |
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 $323.59 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $323.59 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $489.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
Where Michigan sits
The same service costs 4.1 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 $7,274MT $1,783
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.