How much rates vary
Facilitymedian $2,138 · 10th to 90th $331 to $6,918Professionalmedian $251 · 10th to 90th $138 to $490
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 $194.98 Median $4,570.88 Typical High $10,000.00 | Facility | None | $194.98 | $4,570.88 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $309.03 | Professional | None | $173.78 | $251.19 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,570.40 | Facility | None | $954.99 | $1,659.59 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $489.78 | Professional | None | $138.04 | $245.47 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $588.84 | Professional | None | $416.87 | $562.34 | $588.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $8,317.64 | Facility | None | $1,659.59 | $3,019.95 | $8,317.64 |
Horizon BCBS Setting Professional Modifier None Typical Low $218.78 Median $389.05 Typical High $575.44 | Professional | None | $218.78 | $389.05 | $575.44 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $104.71 Median $208.93 Typical High $446.68 | Professional | None | $104.71 | $208.93 | $446.68 |
5 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 $87.10 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $56.23 | Professional | 53 · Discontinued | $35.48 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $186.21 Typical High $208.93 | Professional | 54 · Surgery only | $131.83 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $25.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $25.12 | $27.54 |
Where New Jersey sits
The same service costs 6.1 times more in Michigan than in Montana. 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
MI $4,783MT $790
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.