How much rates vary
Facilitymedian $5,888 · 10th to 90th $513 to $9,120Professionalmedian $1,905 · 10th to 90th $1,349 to $3,236
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 $1,862.09 Median $1,995.26 Typical High $4,897.79 | Facility | None | $1,862.09 | $1,995.26 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,905.46 | $1,995.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $10,232.93 | Facility | None | $5,888.44 | $5,888.44 | $10,232.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,258.93 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,174.90 | $1,949.84 | $3,981.07 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $4,897.79 | Facility | None | $1,698.24 | $4,466.84 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,819.70 | $2,398.83 |
Priority Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,949.84 | $2,884.03 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,778.28 | $1,949.84 | $2,570.40 |
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 $758.58 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $758.58 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,148.15 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $229.09 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,318.26 | $1,318.26 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | 50 · Both sides | $3,388.44 | $3,388.44 | $3,388.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $912.01 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
Where Michigan sits
The same service costs 14.2 times more in Maine than in Maryland. 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
ME $31,650MD $2,222
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.