How much rates vary
Facilitymedian $4,266 · 10th to 90th $550 to $6,918Professionalmedian $1,622 · 10th to 90th $1,230 to $2,455
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 $1,621.81 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,621.81 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,659.59 | $1,698.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $4,265.80 Typical High $7,413.10 | Facility | None | $3,801.89 | $4,265.80 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $275.42 Median $1,737.80 Typical High $2,454.71 | Professional | None | $275.42 | $1,737.80 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $1,862.09 | Professional | None | $912.01 | $1,548.82 | $1,862.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,621.81 Median $3,630.78 Typical High $6,918.31 | Facility | None | $1,621.81 | $3,630.78 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,513.56 | $1,737.80 |
Priority Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,862.09 | Professional | None | $851.14 | $1,148.15 | $1,862.09 |
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 $1,412.54 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,778.28 | $2,238.72 |
11 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 $645.65 Median $831.76 Typical High $851.14 | Professional | 52 · Reduced service | $645.65 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $257.04 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $977.24 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $194.98 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $169.82 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $169.82 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 50 · Both sides | $2,630.27 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $776.25 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Where Michigan sits
The same service costs 15.0 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 $27,402MD $1,821
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.