How much rates vary
Facilitymedian $5,129 · 10th to 90th $550 to $8,128Professionalmedian $1,905 · 10th to 90th $1,202 to $2,291
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 $1,905.46 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,905.46 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,949.84 | $2,041.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,677.35 Median $5,248.07 Typical High $8,912.51 | Facility | None | $4,677.35 | $5,248.07 | $8,912.51 |
BCBS Michigan Setting Professional Modifier None Typical Low $380.19 Median $1,905.46 Typical High $2,041.74 | Professional | None | $380.19 | $1,905.46 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,862.09 | $2,187.76 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,905.46 Median $4,365.16 Typical High $5,754.40 | Facility | None | $1,905.46 | $4,365.16 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,737.80 | $2,137.96 |
Priority Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,380.38 | $2,187.76 |
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 $1,698.24 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,187.76 | $2,754.23 |
10 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 $977.24 Typical High $1,023.29 | Professional | 52 · Reduced service | $758.58 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $389.05 Typical High $407.38 | Professional | 53 · Discontinued | $302.00 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,445.44 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,148.15 | $1,445.44 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $295.12 Typical High $302.00 | Professional | 55 · Aftercare only | $229.09 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $194.98 Typical High $204.17 | Professional | 56 · Pre-op care only | $151.36 | $194.98 | $204.17 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $912.01 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $363.08 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,380.38 | $1,412.54 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $275.42 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $181.97 | $190.55 | $190.55 |
Where Michigan sits
The same service costs 25.6 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 $53,236MD $2,076
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.