How much rates vary
Facilitymedian $2,344 · 10th to 90th $724 to $5,495Professionalmedian $2,188 · 10th to 90th $2,089 to $3,715
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 $2,089.30 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,089.30 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,023.29 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $416.87 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,548.82 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $309.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $208.93 | $218.78 | $218.78 |
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 $56,234.13 Median $56,234.13 Typical High $56,234.13 | Professional | None | $56,234.13 | $56,234.13 | $56,234.13 |
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 $2,089.30 Median $2,187.76 Typical High $4,073.80 | Professional | None | $2,089.30 | $2,187.76 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
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 $2,089.30 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,089.30 | $2,187.76 | $2,187.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,023.29 | $1,096.48 | $1,096.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $416.87 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,548.82 | $1,659.59 | $1,659.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $309.03 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $208.93 | $218.78 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,137.96 | $4,466.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,778.28 Median $3,388.44 Typical High $5,128.61 | Facility | None | $1,778.28 | $3,388.44 | $5,128.61 |
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 $2,041.74 Median $2,398.83 Typical High $4,570.88 | Professional | None | $2,041.74 | $2,398.83 | $4,570.88 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,041.74 Typical High $2,137.96 | Professional | 50 · Both sides | $2,041.74 | $2,041.74 | $2,137.96 |
Where Pennsylvania sits
The same service costs 7.1 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· 44th of 51
$2,188
AK $9,772KY $1,380
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.