How much rates vary
Facilitymedian $186 · 10th to 90th $50 to $3,981Professionalmedian $60 · 10th to 90th $30 to $123
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 $30.90 Median $2,818.38 Typical High $8,511.38 | Facility | None | $30.90 | $2,818.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $60.26 Typical High $112.20 | Professional | None | $29.51 | $60.26 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $21.38 Typical High $47.86 | Professional | 52 · Reduced service | $14.79 | $21.38 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $8.51 Typical High $19.05 | Professional | 53 · Discontinued | $5.89 | $8.51 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $32.36 Typical High $72.44 | Professional | 54 · Surgery only | $22.39 | $32.36 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $7.94 Typical High $14.45 | Professional | 55 · Aftercare only | $4.47 | $7.94 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $5.25 Typical High $9.55 | Professional | 56 · Pre-op care only | $2.95 | $5.25 | $9.55 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | None | $91.20 | $144.54 | $144.54 |
AmeriHealth Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | None | $47.86 | $47.86 | $61.66 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $234.42 | Professional | None | $134.90 | $134.90 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $61.66 Typical High $117.49 | Professional | None | $26.30 | $61.66 | $117.49 |
Emblem Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Geisinger Setting Professional Modifier None Typical Low $37.15 Median $100.00 Typical High $158.49 | Professional | None | $37.15 | $100.00 | $158.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $407.38 Median $1,513.56 Typical High $2,290.87 | Facility | None | $407.38 | $1,513.56 | $2,290.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $45.71 Median $97.72 Typical High $125.89 | Professional | None | $45.71 | $97.72 | $125.89 |
Independence Blue Cross Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | None | $47.86 | $47.86 | $61.66 |
Martin's Point Setting Facility Modifier None Typical Low $93.33 Median $2,818.38 Typical High $8,511.38 | Facility | None | $93.33 | $2,818.38 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $29.51 Median $60.26 Typical High $107.15 | Professional | None | $29.51 | $60.26 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $21.38 Typical High $47.86 | Professional | 52 · Reduced service | $14.79 | $21.38 | $47.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $8.51 Typical High $19.05 | Professional | 53 · Discontinued | $5.89 | $8.51 | $19.05 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $32.36 Typical High $72.44 | Professional | 54 · Surgery only | $22.39 | $32.36 | $72.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $6.46 Typical High $14.45 | Professional | 55 · Aftercare only | $4.47 | $6.46 | $14.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $8.51 Typical High $9.55 | Professional | 56 · Pre-op care only | $2.95 | $8.51 | $9.55 |
Oscar Health Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $134.90 | Professional | None | $66.07 | $66.07 | $134.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $38.02 Median $190.55 Typical High $416.87 | Facility | None | $38.02 | $190.55 | $416.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $33.11 Median $60.26 Typical High $97.72 | Professional | None | $33.11 | $60.26 | $97.72 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,348.96 | Facility | None | $77.62 | $158.49 | $1,348.96 |
United Setting Professional Modifier None Typical Low $31.62 Median $67.61 Typical High $134.90 | Professional | None | $31.62 | $67.61 | $134.90 |
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 Professional Modifier 59 · Distinct service Typical Low $91.20 Median $97.72 Typical High $102.33 | Professional | 59 · Distinct service | $91.20 | $97.72 | $102.33 |
Where Pennsylvania sits
The same service costs 3.3 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· 46th of 51
$66.07
AK $170KY $51.29
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.