How much rates vary
Facilitymedian $1,862 · 10th to 90th $562 to $5,495Professionalmedian $251 · 10th to 90th $123 to $479
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 $257.04 Median $3,801.89 Typical High $8,317.64 | Facility | None | $257.04 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $257.04 | Professional | None | $123.03 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $85.11 Typical High $128.82 | Professional | 52 · Reduced service | $61.66 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $51.29 | Professional | 53 · Discontinued | $24.55 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $128.82 Typical High $194.98 | Professional | 54 · Surgery only | $93.33 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.70 Typical High $38.90 | Professional | 55 · Aftercare only | $18.62 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.98 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.30 | $16.98 | $25.70 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $537.03 | Professional | None | $263.03 | $436.52 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $2,630.27 | Facility | None | $501.19 | $1,548.82 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $446.68 | Professional | None | $131.83 | $199.53 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | None | $478.63 | $478.63 | $501.19 |
Geisinger Setting Facility Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,548.82 | $1,949.84 | $3,388.44 |
Geisinger Setting Professional Modifier None Typical Low $138.04 Median $288.40 Typical High $467.74 | Professional | None | $138.04 | $288.40 | $467.74 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $3,715.35 Typical High $8,317.64 | Facility | None | $588.84 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $257.04 | Professional | None | $123.03 | $239.88 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $85.11 Typical High $128.82 | Professional | 52 · Reduced service | $61.66 | $85.11 | $128.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $51.29 | Professional | 53 · Discontinued | $24.55 | $34.67 | $51.29 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $128.82 Typical High $194.98 | Professional | 54 · Surgery only | $93.33 | $128.82 | $194.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.70 Typical High $38.90 | Professional | 55 · Aftercare only | $18.62 | $25.70 | $38.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.98 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.30 | $16.98 | $25.70 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $478.63 | Professional | None | $295.12 | $316.23 | $478.63 |
UPMC Health Plan Setting Facility Modifier None Typical Low $117.49 Median $812.83 Typical High $1,862.09 | Facility | None | $117.49 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $331.13 | Professional | None | $117.49 | $263.03 | $331.13 |
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 $131.83 Median $239.88 Typical High $457.09 | Professional | None | $131.83 | $239.88 | $457.09 |
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 $389.05 Median $645.65 Typical High $794.33 | Professional | 50 · Both sides | $389.05 | $645.65 | $794.33 |
Where Pennsylvania sits
The same service costs 5.8 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· 39th of 51
$263
AK $955HI $166
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.