How much rates vary
Facilitymedian $8,511 · 10th to 90th $501 to $13,183Professionalmedian $2,951 · 10th to 90th $1,995 to $3,388
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 $3,019.95 Median $3,162.28 Typical High $6,918.31 | Facility | None | $3,019.95 | $3,162.28 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,019.95 | $3,162.28 | $3,162.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,511.38 Median $8,709.64 Typical High $15,135.61 | Facility | None | $8,511.38 | $8,709.64 | $15,135.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $676.08 Median $3,388.44 Typical High $3,630.78 | Professional | None | $676.08 | $3,388.44 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $4,570.88 | Professional | None | $1,862.09 | $2,691.53 | $4,570.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,951.21 Median $6,456.54 Typical High $7,079.46 | Facility | None | $2,951.21 | $6,456.54 | $7,079.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,951.21 | $3,388.44 |
Priority Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,691.53 | $3,467.37 |
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 $2,398.83 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,398.83 | $2,691.53 | $3,019.95 |
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 $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,513.56 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $602.56 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,290.87 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $457.09 | $478.63 | $478.63 |
Aetna 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 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,238.72 | $2,238.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,479.11 | $1,548.82 | $1,548.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $588.84 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,238.72 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $446.68 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $295.12 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,137.96 | $2,137.96 |
Where Michigan sits
The same service costs 13.8 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 $35,114TX $2,545
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.