How much rates vary
Facilitymedian $5,888 · 10th to 90th $501 to $9,120Professionalmedian $1,995 · 10th to 90th $1,413 to $2,344
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 $1,995.26 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,995.26 | $1,995.26 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,995.26 | $2,041.74 | $2,041.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $10,232.93 | Facility | None | $5,888.44 | $5,888.44 | $10,232.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $446.68 Median $2,137.96 Typical High $2,238.72 | Professional | None | $446.68 | $2,137.96 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,819.70 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,995.26 Median $4,677.35 Typical High $4,897.79 | Facility | None | $1,995.26 | $4,677.35 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,995.26 | $2,290.87 |
Priority Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,288.25 | $1,737.80 | $2,951.21 |
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 $1,778.28 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,778.28 | $2,238.72 | $2,511.89 |
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 $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,445.44 | $1,445.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $407.38 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Michigan sits
The same service costs 8.2 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 $17,891MD $2,184
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.