How much rates vary
Facilitymedian $324 · 10th to 90th $85 to $1,820Professionalmedian $112 · 10th to 90th $87 to $200
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 $107.15 Median $436.52 Typical High $4,168.69 | Facility | None | $107.15 | $436.52 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $169.82 | Professional | None | $91.20 | $107.15 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $70.79 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $63.10 | $70.79 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $245.47 | Professional | None | $120.23 | $123.03 | $245.47 |
AmeriHealth Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $13,803.84 | Facility | None | $2,951.21 | $2,951.21 | $13,803.84 |
AmeriHealth Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $114.82 | Professional | None | $57.54 | $95.50 | $114.82 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $8,709.64 | Facility | None | $1,202.26 | $1,412.54 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $275.42 | Professional | None | $125.89 | $128.82 | $275.42 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $104.71 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $100.00 | $104.71 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $173.78 | Facility | None | $50.12 | $100.00 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $199.53 | Professional | None | $85.11 | $104.71 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Geisinger Setting Facility Modifier None Typical Low $83.18 Median $102.33 Typical High $181.97 | Facility | None | $83.18 | $102.33 | $181.97 |
Geisinger Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $213.80 | Professional | None | $95.50 | $144.54 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $275.42 Median $467.74 Typical High $794.33 | Facility | None | $275.42 | $467.74 | $794.33 |
Highmark BCBS Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $173.78 | Professional | None | $109.65 | $123.03 | $173.78 |
Independence Blue Cross Setting Facility Modifier None Typical Low $758.58 Median $14,791.08 Typical High $30,199.52 | Facility | None | $758.58 | $14,791.08 | $30,199.52 |
Independence Blue Cross Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $117.49 | Professional | None | $57.54 | $97.72 | $117.49 |
Martin's Point Setting Facility Modifier None Typical Low $107.15 Median $457.09 Typical High $3,801.89 | Facility | None | $107.15 | $457.09 | $3,801.89 |
Martin's Point Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $177.83 | Professional | None | $91.20 | $107.15 | $177.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $70.79 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $63.10 | $70.79 | $79.43 |
Oscar Health Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $213.80 | Professional | None | $89.13 | $89.13 | $213.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $436.52 | Facility | None | $87.10 | $190.55 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $120.23 | Professional | None | $87.10 | $102.33 | $120.23 |
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 $89.13 Median $109.65 Typical High $199.53 | Professional | None | $89.13 | $109.65 | $199.53 |
10 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 $44.67 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $44.67 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $18.20 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | 54 · Surgery only | $67.61 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $44.67 | $51.29 | $57.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $18.20 | $20.42 | $22.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | 54 · Surgery only | $67.61 | $75.86 | $85.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $16.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $11.48 |
Where Pennsylvania sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 41st of 51
$115
AK $437KY $100
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.