How much rates vary
Facilitymedian $3,802 · 10th to 90th $537 to $9,772Professionalmedian $1,413 · 10th to 90th $891 to $1,995
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 $1,380.38 Median $1,445.44 Typical High $5,754.40 | Facility | None | $1,380.38 | $1,445.44 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,445.44 | $1,548.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $4,786.30 Typical High $11,748.98 | Facility | None | $3,801.89 | $4,786.30 | $11,748.98 |
BCBS Michigan Setting Professional Modifier None Typical Low $275.42 Median $1,479.11 Typical High $2,041.74 | Professional | None | $275.42 | $1,479.11 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $1,584.89 | Professional | None | $776.25 | $1,380.38 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,445.44 Median $4,073.80 Typical High $7,585.78 | Facility | None | $1,445.44 | $4,073.80 | $7,585.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,348.96 | $1,698.24 |
Priority Health Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,584.89 | Professional | None | $724.44 | $1,000.00 | $1,584.89 |
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 $1,258.93 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,621.81 | $1,949.84 |
9 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 54 · Surgery only Typical Low $851.14 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $851.14 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $169.82 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $141.25 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $794.33 | $977.24 | $1,023.29 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 50 · Both sides | $2,187.76 | $2,187.76 | $2,187.76 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $954.99 |
Where Michigan sits
The same service costs 9.4 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 $15,900MD $1,684
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.