How much rates vary
Facilitymedian $7,079 · 10th to 90th $501 to $10,965Professionalmedian $2,455 · 10th to 90th $550 to $3,890
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 $2,511.89 Median $2,570.40 Typical High $6,918.31 | Facility | None | $2,511.89 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,691.53 | $2,691.53 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $12,302.69 | Facility | None | $7,079.46 | $7,079.46 | $12,302.69 |
BCBS Michigan Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $4,073.80 | Professional | None | $467.74 | $812.83 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $6,918.31 | Professional | None | $1,548.82 | $2,344.23 | $6,918.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,454.71 Median $5,495.41 Typical High $6,025.60 | Facility | None | $2,454.71 | $5,495.41 | $6,025.60 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,041.74 Median $2,570.40 Typical High $3,311.31 | Professional | None | $2,041.74 | $2,570.40 | $3,311.31 |
Priority Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,570.40 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,570.40 | $3,311.31 |
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 $2,137.96 Median $2,344.23 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,344.23 | $3,162.28 |
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 $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $977.24 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $389.05 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,445.44 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $295.12 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $194.98 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,862.09 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,230.27 | $1,258.93 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $489.78 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,819.70 | $1,905.46 | $1,905.46 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $371.54 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $245.47 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,778.28 | $1,778.28 |
Where Michigan sits
The same service costs 13.4 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 $34,930MD $2,604
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.