How much rates vary
Facilitymedian $3,548 · 10th to 90th $501 to $5,623Professionalmedian $1,148 · 10th to 90th $912 to $1,413
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 $1,096.48 Median $1,096.48 Typical High $6,918.31 | Facility | None | $1,096.48 | $1,096.48 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | None | $977.24 | $1,096.48 | $1,096.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $6,165.95 | Facility | None | $3,548.13 | $3,548.13 | $6,165.95 |
BCBS Michigan Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,202.26 | Professional | None | $741.31 | $1,202.26 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $2,754.23 | Professional | None | $630.96 | $1,096.48 | $2,754.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $4,897.79 | Facility | None | $1,096.48 | $2,818.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,380.38 | Professional | None | $954.99 | $1,096.48 | $1,380.38 |
Priority Health Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $1,288.25 | Professional | None | $630.96 | $1,096.48 | $1,288.25 |
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 $1,071.52 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,230.27 | $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 $537.03 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | 54 · Surgery only | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $776.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Michigan sits
The same service costs 10.9 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 $16,718MD $1,540
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.