How much rates vary
Facilitymedian $4,266 · 10th to 90th $977 to $6,918Professionalmedian $1,445 · 10th to 90th $977 to $1,698
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 $1,412.54 Median $1,479.11 Typical High $4,897.79 | Facility | None | $1,412.54 | $1,479.11 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,479.11 | $1,548.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,265.80 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $316.23 Median $977.24 Typical High $1,584.89 | Professional | None | $316.23 | $977.24 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $3,467.37 | Professional | None | $891.25 | $1,258.93 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,479.11 Median $3,162.28 Typical High $4,897.79 | Facility | None | $1,479.11 | $3,162.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,445.44 | $1,819.70 |
Priority Health Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,819.70 | Professional | None | $891.25 | $1,258.93 | $1,819.70 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,025.60 | Facility | None | $660.69 | $1,548.82 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,513.56 | $1,905.46 |
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 $630.96 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $190.55 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $128.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $891.25 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $691.83 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $275.42 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $138.04 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,000.00 |
Where Michigan sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.