How much rates vary
Facilitymedian $7,413 · 10th to 90th $501 to $11,482Professionalmedian $2,570 · 10th to 90th $490 to $2,951
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 $2,570.40 Median $2,570.40 Typical High $6,918.31 | Facility | None | $2,570.40 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,570.40 | $2,630.27 | $2,630.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,413.10 Median $7,585.78 Typical High $13,182.57 | Facility | None | $7,413.10 | $7,585.78 | $13,182.57 |
BCBS Michigan Setting Professional Modifier None Typical Low $489.78 Median $1,778.28 Typical High $2,884.03 | Professional | None | $489.78 | $1,778.28 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $4,073.80 | Professional | None | $1,698.24 | $2,290.87 | $4,073.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $5,623.41 Typical High $6,165.95 | Facility | None | $2,570.40 | $5,623.41 | $6,165.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,570.40 | $2,951.21 |
Priority Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,659.59 | $2,238.72 | $3,801.89 |
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 $2,290.87 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,290.87 | $2,884.03 | $3,162.28 |
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 $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,288.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,949.84 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,862.09 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $512.86 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $1,949.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,819.70 |
Where Michigan sits
The same service costs 6.9 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 $18,419MD $2,652
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.