How much rates vary
Facilitymedian $3,715 · 10th to 90th $490 to $5,888Professionalmedian $1,288 · 10th to 90th $251 to $1,479
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 $1,318.26 Median $1,318.26 Typical High $6,918.31 | Facility | None | $1,318.26 | $1,318.26 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $6,606.93 | Facility | None | $3,715.35 | $3,801.89 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $251.19 Median $933.25 Typical High $1,479.11 | Professional | None | $251.19 | $933.25 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,995.26 | Professional | None | $851.14 | $1,174.90 | $1,995.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,288.25 Median $3,019.95 Typical High $4,897.79 | Facility | None | $1,288.25 | $3,019.95 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,288.25 | $1,479.11 |
Priority Health Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,905.46 | Professional | None | $831.76 | $1,096.48 | $1,905.46 |
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 $1,148.15 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,412.54 | $1,584.89 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $933.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Where Michigan sits
The same service costs 10.6 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 $17,137MD $1,609
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.