How much rates vary
Facilitymedian $4,677 · 10th to 90th $501 to $7,244Professionalmedian $1,622 · 10th to 90th $347 to $1,862
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 $1,621.81 Median $1,659.59 Typical High $6,918.31 | Facility | None | $1,621.81 | $1,659.59 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,659.59 | $1,659.59 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $8,128.31 | Facility | None | $4,677.35 | $4,786.30 | $8,128.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $295.12 Median $1,659.59 Typical High $1,737.80 | Professional | None | $295.12 | $1,659.59 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,981.07 | Professional | None | $933.25 | $1,445.44 | $3,981.07 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,584.89 Median $3,715.35 Typical High $4,897.79 | Facility | None | $1,584.89 | $3,715.35 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,584.89 | $1,949.84 |
Priority Health Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,819.70 | Professional | None | $933.25 | $1,445.44 | $1,819.70 |
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 $1,445.44 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,698.24 | $2,089.30 |
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 $707.95 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Michigan sits
The same service costs 9.0 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 $17,266MD $1,911
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.