How much rates vary
Facilitymedian $6,918 · 10th to 90th $501 to $10,715Professionalmedian $2,399 · 10th to 90th $631 to $3,162
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 $2,398.83 Median $2,511.89 Typical High $6,918.31 | Facility | None | $2,398.83 | $2,511.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,398.83 | $2,570.40 | $2,570.40 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,918.31 Median $7,079.46 Typical High $12,022.64 | Facility | None | $6,918.31 | $7,079.46 | $12,022.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $478.63 Median $2,398.83 Typical High $3,388.44 | Professional | None | $478.63 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $3,715.35 | Professional | None | $1,479.11 | $2,187.76 | $3,715.35 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,344.23 Median $5,370.32 Typical High $5,888.44 | Facility | None | $2,344.23 | $5,370.32 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,454.71 | $2,818.38 |
Priority Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,479.11 | $2,187.76 | $2,818.38 |
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 $1,949.84 Median $2,238.72 Typical High $2,454.71 | Professional | None | $1,949.84 | $2,238.72 | $2,454.71 |
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 $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,202.26 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $478.63 | $512.86 | $512.86 |
Aetna 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 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $239.88 | $257.04 | $257.04 |
Aetna 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 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,174.90 | $1,230.27 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $467.74 | $489.78 | $489.78 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,778.28 | $1,862.09 | $1,862.09 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $354.81 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,737.80 | $1,737.80 |
Where Michigan sits
The same service costs 14.4 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 $34,547MD $2,395
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.