How much rates vary
Facilitymedian $2,239 · 10th to 90th $724 to $5,495Professionalmedian $1,122 · 10th to 90th $479 to $1,585
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 $891.25 Median $3,890.45 Typical High $8,317.64 | Facility | None | $891.25 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,148.15 | $1,148.15 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | None | $478.63 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,819.70 Typical High $3,090.30 | Facility | None | $524.81 | $1,819.70 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,148.15 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Geisinger Setting Facility Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $4,168.69 | Facility | None | $1,905.46 | $2,344.23 | $4,168.69 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $8,317.64 | Facility | None | $954.99 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,148.15 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $3,715.35 | Facility | None | $1,047.13 | $1,862.09 | $3,715.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,047.13 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,288.25 | $2,398.83 |
11 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 $549.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | 50 · Both sides | $478.63 | $478.63 | $501.19 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $218.78 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $870.96 | $870.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Where Pennsylvania sits
The same service costs 4.8 times more in Alaska than in New York. 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· 48th of 51
$1,148
AK $5,129NY $1,072
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.