How much rates vary
Facilitymedian $6,607 · 10th to 90th $501 to $10,471Professionalmedian $2,291 · 10th to 90th $1,862 to $2,630
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 $2,290.87 Median $2,290.87 Typical High $6,918.31 | Facility | None | $2,290.87 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,606.93 Median $6,760.83 Typical High $11,481.54 | Facility | None | $6,606.93 | $6,760.83 | $11,481.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,584.89 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,445.44 | $1,949.84 | $3,630.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,290.87 Median $5,011.87 Typical High $5,370.32 | Facility | None | $2,290.87 | $5,011.87 | $5,370.32 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,290.87 | $2,630.27 |
Priority Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,445.44 | $1,949.84 | $3,388.44 |
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 $1,995.26 Median $2,454.71 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,454.71 | $2,818.38 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $457.09 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,698.24 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,621.81 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $457.09 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,584.89 |
Where Michigan sits
The same service costs 7.6 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 $18,140MD $2,382
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.