How much rates vary
Facilitymedian $8,710 · 10th to 90th $501 to $13,490Professionalmedian $3,020 · 10th to 90th $2,042 to $3,548
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 $3,090.30 Median $3,162.28 Typical High $6,918.31 | Facility | None | $3,090.30 | $3,162.28 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,290.87 | $3,235.94 | $3,235.94 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,709.64 Median $8,912.51 Typical High $15,135.61 | Facility | None | $8,709.64 | $8,912.51 | $15,135.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $691.83 Median $3,235.94 Typical High $3,630.78 | Professional | None | $691.83 | $3,235.94 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $4,677.35 | Professional | None | $1,905.46 | $2,754.23 | $4,677.35 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,019.95 Median $6,760.83 Typical High $7,413.10 | Facility | None | $3,019.95 | $6,760.83 | $7,413.10 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,548.13 | Professional | None | $2,511.89 | $3,090.30 | $3,548.13 |
Priority Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $3,548.13 | Professional | None | $1,905.46 | $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 $2,454.71 Median $2,691.53 Typical High $3,090.30 | Professional | None | $2,454.71 | $2,691.53 | $3,090.30 |
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 $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,548.82 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $616.60 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,290.87 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $457.09 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,513.56 | $1,584.89 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $602.56 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,290.87 | $2,344.23 | $2,344.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $457.09 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $302.00 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,187.76 | $2,187.76 |
Where Michigan sits
The same service costs 12.4 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 $35,178WA $2,843
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.