How much rates vary
Facilitymedian $7,943 · 10th to 90th $501 to $12,303Professionalmedian $2,754 · 10th to 90th $1,905 to $3,162
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 $2,818.38 Median $2,818.38 Typical High $6,918.31 | Facility | None | $2,818.38 | $2,818.38 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,943.28 Median $8,128.31 Typical High $14,125.38 | Facility | None | $7,943.28 | $8,128.31 | $14,125.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $616.60 Median $1,905.46 Typical High $3,090.30 | Professional | None | $616.60 | $1,905.46 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $4,265.80 | Professional | None | $1,819.70 | $2,511.89 | $4,265.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,754.23 Median $6,025.60 Typical High $6,606.93 | Facility | None | $2,754.23 | $6,025.60 | $6,606.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,754.23 | $3,162.28 |
Priority Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $4,073.80 | Professional | None | $1,778.28 | $2,398.83 | $4,073.80 |
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 $2,454.71 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,454.71 | $3,019.95 | $3,388.44 |
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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $562.34 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,089.30 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,380.38 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $562.34 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,089.30 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $1,949.84 |
Where Michigan sits
The same service costs 7.6 times more in Maine than in Texas. 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 $18,667TX $2,469
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.