How much rates vary
Facilitymedian $3,981 · 10th to 90th $513 to $6,918Professionalmedian $1,380 · 10th to 90th $1,000 to $2,344
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 $1,047.13 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,047.13 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,412.54 | $1,412.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $4,073.80 Typical High $6,918.31 | Facility | None | $3,981.07 | $4,073.80 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $263.03 Median $1,659.59 Typical High $2,344.23 | Professional | None | $263.03 | $1,659.59 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $3,162.28 | Professional | None | $831.76 | $1,348.96 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,380.38 Median $3,235.94 Typical High $6,918.31 | Facility | None | $1,380.38 | $3,235.94 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,380.38 | $1,548.82 |
Priority Health Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $1,949.84 | Professional | None | $831.76 | $1,348.96 | $1,949.84 |
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 $1,202.26 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,318.26 | $1,737.80 |
13 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 $524.81 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $524.81 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $208.93 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $776.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $154.88 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $104.71 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $724.44 | $977.24 | $977.24 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 50 · Both sides | $2,511.89 | $2,511.89 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $977.24 |
Where Michigan sits
The same service costs 16.4 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 $28,429MD $1,737
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.