How much rates vary
Facilitymedian $158 · 10th to 90th $59 to $3,631Professionalmedian $91 · 10th to 90th $55 to $135
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 $91.20 Median $2,344.23 Typical High $8,317.64 | Facility | None | $91.20 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $91.20 | Professional | None | $52.48 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $32.36 Typical High $45.71 | Professional | 52 · Reduced service | $26.30 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.88 Typical High $18.20 | Professional | 53 · Discontinued | $10.47 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $48.98 Typical High $69.18 | Professional | 54 · Surgery only | $38.90 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.77 Typical High $13.80 | Professional | 55 · Aftercare only | $7.76 | $9.77 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.46 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.25 | $6.46 | $9.12 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | None | $97.72 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $91.20 Typical High $691.83 | Facility | None | $54.95 | $91.20 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Geisinger Setting Facility Modifier None Typical Low $53.70 Median $66.07 Typical High $117.49 | Facility | None | $53.70 | $66.07 | $117.49 |
Geisinger Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $144.54 | Professional | None | $91.20 | $104.71 | $144.54 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $91.20 | Professional | None | $52.48 | $77.62 | $91.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $30.90 Typical High $45.71 | Professional | 52 · Reduced service | $26.30 | $30.90 | $45.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.30 Typical High $18.20 | Professional | 53 · Discontinued | $10.47 | $12.30 | $18.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $46.77 Typical High $69.18 | Professional | 54 · Surgery only | $38.90 | $46.77 | $69.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.33 Typical High $13.80 | Professional | 55 · Aftercare only | $7.76 | $9.33 | $13.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.17 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.25 | $6.17 | $9.12 |
UPMC Health Plan Setting Facility Modifier None Typical Low $64.57 Median $74.13 Typical High $112.20 | Facility | None | $64.57 | $74.13 | $112.20 |
UPMC Health Plan Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $112.20 | Professional | None | $64.57 | $93.33 | $112.20 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $162.18 | Professional | None | $63.10 | $97.72 | $162.18 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | PN · Off-campus dept, non-excepted | $371.54 | $371.54 | $371.54 |
Where Pennsylvania sits
The same service costs 3.4 times more in Alaska than in Virginia. 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.
Pennsylvania· 47th of 51
$91.20
AK $263VA $77.62
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.