How much rates vary
Facilitymedian $4,786 · 10th to 90th $501 to $7,586Professionalmedian $1,778 · 10th to 90th $1,479 to $2,692
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 $1,778.28 Median $1,819.70 Typical High $6,918.31 | Facility | None | $1,778.28 | $1,819.70 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,819.70 | $1,905.46 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,786.30 Median $4,897.79 Typical High $8,511.38 | Facility | None | $4,786.30 | $4,897.79 | $8,511.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,737.80 | $2,041.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,698.24 Median $4,365.16 Typical High $4,897.79 | Facility | None | $1,698.24 | $4,365.16 | $4,897.79 |
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 $933.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $933.25 | $1,288.25 | $2,041.74 |
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 $1,548.82 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,548.82 | $2,041.74 | $2,398.83 |
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 $707.95 Median $912.01 Typical High $954.99 | Professional | 52 · Reduced service | $707.95 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $363.08 Typical High $380.19 | Professional | 53 · Discontinued | $281.84 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,071.52 | $1,348.96 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $275.42 Typical High $281.84 | Professional | 55 · Aftercare only | $213.80 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $181.97 Typical High $190.55 | Professional | 56 · Pre-op care only | $141.25 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,258.93 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,258.93 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $1,230.27 |
Where Michigan sits
The same service costs 8.1 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 $15,945MD $1,975
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.