How much rates vary
Facilitymedian $3,020 · 10th to 90th $550 to $4,898Professionalmedian $1,096 · 10th to 90th $692 to $1,349
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 $1,096.48 Median $1,122.02 Typical High $6,918.31 | Facility | None | $1,096.48 | $1,122.02 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,174.90 | Professional | None | $870.96 | $1,122.02 | $1,174.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,019.95 | $5,128.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $223.87 Median $1,122.02 Typical High $1,202.26 | Professional | None | $223.87 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,288.25 | Professional | None | $616.60 | $1,071.52 | $1,288.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,047.13 Median $2,511.89 Typical High $6,918.31 | Facility | None | $1,047.13 | $2,511.89 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,202.26 | Professional | None | $851.14 | $1,047.13 | $1,202.26 |
Priority Health Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,288.25 | Professional | None | $575.44 | $794.33 | $1,288.25 |
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 $977.24 Median $1,258.93 Typical High $1,548.82 | Professional | None | $977.24 | $1,258.93 | $1,548.82 |
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 $436.52 Median $562.34 Typical High $588.84 | Professional | 52 · Reduced service | $436.52 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $223.87 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $851.14 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $131.83 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $112.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $87.10 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $794.33 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $794.33 | $812.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $758.58 |
Where Michigan sits
The same service costs 18.7 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 $26,826MD $1,433
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.