How much rates vary
Facilitymedian $933 · 10th to 90th $380 to $3,890Professionalmedian $135 · 10th to 90th $63 to $275
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 $144.54 Median $2,137.96 Typical High $8,317.64 | Facility | None | $144.54 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $144.54 | Professional | None | $60.26 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $42.66 Typical High $72.44 | Professional | 52 · Reduced service | $30.20 | $42.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $28.84 | Professional | 53 · Discontinued | $12.02 | $17.38 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $83.18 Typical High $109.65 | Professional | 54 · Surgery only | $45.71 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $16.60 Typical High $21.88 | Professional | 55 · Aftercare only | $9.12 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $10.96 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.03 | $10.96 | $14.45 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $8,709.64 | Facility | None | $2,454.71 | $2,570.40 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $309.03 | Professional | None | $141.25 | $245.47 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $724.44 Typical High $1,412.54 | Facility | None | $338.84 | $724.44 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $245.47 | Professional | None | $64.57 | $131.83 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $281.84 | Professional | None | $269.15 | $269.15 | $281.84 |
Geisinger Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,584.89 | Facility | None | $724.44 | $891.25 | $1,584.89 |
Geisinger Setting Professional Modifier None Typical Low $74.13 Median $162.18 Typical High $269.15 | Professional | None | $74.13 | $162.18 | $269.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Highmark BCBS Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $218.78 | Professional | None | $144.54 | $169.82 | $218.78 |
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 $60.26 Median $134.90 Typical High $144.54 | Professional | None | $60.26 | $134.90 | $144.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $42.66 Typical High $72.44 | Professional | 52 · Reduced service | $30.20 | $42.66 | $72.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $28.84 | Professional | 53 · Discontinued | $12.02 | $17.38 | $28.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $83.18 Typical High $109.65 | Professional | 54 · Surgery only | $45.71 | $83.18 | $109.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $16.60 Typical High $21.88 | Professional | 55 · Aftercare only | $9.12 | $16.60 | $21.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $10.96 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.03 | $10.96 | $14.45 |
Oscar Health Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $275.42 | Professional | None | $173.78 | $181.97 | $275.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $87.10 Median $812.83 Typical High $1,862.09 | Facility | None | $87.10 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $67.61 Median $134.90 Typical High $144.54 | Professional | None | $67.61 | $134.90 | $144.54 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,630.78 | Facility | None | $416.87 | $724.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $64.57 Median $128.82 Typical High $245.47 | Professional | None | $64.57 | $128.82 | $245.47 |
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 $213.80 Median $371.54 Typical High $457.09 | Professional | 50 · Both sides | $213.80 | $371.54 | $457.09 |
Where Pennsylvania sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 38th of 51
$145
AK $437HI $89.13
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.