How much rates vary
Facilitymedian $7,586 · 10th to 90th $501 to $11,749Professionalmedian $2,692 · 10th to 90th $1,950 to $4,266
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 $2,630.27 Median $2,754.23 Typical High $6,918.31 | Facility | None | $2,630.27 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,818.38 | $2,818.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $13,182.57 | Facility | None | $7,585.78 | $7,585.78 | $13,182.57 |
BCBS Michigan Setting Professional Modifier None Typical Low $489.78 Median $2,884.03 Typical High $4,265.80 | Professional | None | $489.78 | $2,884.03 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $7,244.36 | Professional | None | $1,621.81 | $2,511.89 | $7,244.36 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $5,888.44 Typical High $6,456.54 | Facility | None | $2,570.40 | $5,888.44 | $6,456.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,691.53 | $3,548.13 |
Priority Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $3,548.13 | Professional | None | $1,621.81 | $2,691.53 | $3,548.13 |
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 $2,290.87 Median $2,454.71 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,454.71 | $3,311.31 |
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 $1,023.29 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,023.29 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $416.87 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,548.82 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $204.17 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,288.25 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $524.81 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,949.84 | $2,041.74 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $389.05 | $407.38 | $407.38 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,905.46 | $1,905.46 |
Where Michigan sits
The same service costs 13.8 times more in Maine than in Washington. 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 $35,114WA $2,549
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.