How much rates vary
Facilitymedian $10,965 · 10th to 90th $501 to $16,982Professionalmedian $3,890 · 10th to 90th $3,162 to $6,166
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 $3,801.89 Median $3,890.45 Typical High $6,918.31 | Facility | None | $3,801.89 | $3,890.45 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,162.28 | $4,073.80 | $4,073.80 |
BCBS Michigan Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $19,054.61 | Facility | None | $10,964.78 | $10,964.78 | $19,054.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $2,454.71 Median $5,888.44 Typical High $9,120.11 | Professional | None | $2,454.71 | $5,888.44 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $10,232.93 | Professional | None | $2,344.23 | $3,548.13 | $10,232.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,715.35 Median $8,317.64 Typical High $9,120.11 | Facility | None | $3,715.35 | $8,317.64 | $9,120.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $5,128.61 | Professional | None | $3,162.28 | $3,890.45 | $5,128.61 |
Priority Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,890.45 Typical High $5,011.87 | Professional | None | $2,344.23 | $3,890.45 | $5,011.87 |
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 $3,311.31 Median $3,548.13 Typical High $4,786.30 | Professional | None | $3,311.31 | $3,548.13 | $4,786.30 |
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 $1,548.82 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,548.82 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $616.60 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,290.87 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $457.09 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $309.03 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,818.38 | $2,818.38 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,862.09 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,862.09 | $1,949.84 | $1,949.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $741.31 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,818.38 | $2,884.03 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $562.34 | $575.44 | $575.44 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $371.54 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,691.53 | $2,691.53 |
Where Michigan sits
The same service costs 13.1 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 $36,340TX $2,769
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.