How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,288 to $8,710Professionalmedian $1,738 · 10th to 90th $1,259 to $2,630
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 $1,698.24 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,698.24 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,778.28 | $1,778.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $8,709.64 | Facility | None | $5,011.87 | $5,011.87 | $8,709.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $691.83 Median $1,905.46 Typical High $2,818.38 | Professional | None | $691.83 | $1,905.46 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $4,897.79 | Professional | None | $1,047.13 | $1,659.59 | $4,897.79 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,737.80 Median $4,265.80 Typical High $6,918.31 | Facility | None | $1,737.80 | $4,265.80 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,737.80 | $2,398.83 |
Priority Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,778.28 | $2,344.23 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $8,709.64 | Facility | None | $891.25 | $2,818.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,659.59 | $2,187.76 |
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 $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $1,258.93 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $338.84 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $251.19 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $1,230.27 |
Where Michigan sits
The same service costs 13.5 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 $34,179TX $2,531
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.