How much rates vary
Facilitymedian $151 · 10th to 90th $56 to $3,467Professionalmedian $83 · 10th to 90th $60 to $138
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 $91.20 Median $2,344.23 Typical High $8,317.64 | Facility | None | $91.20 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $91.20 | Professional | None | $58.88 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $29.51 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $11.75 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $58.88 Typical High $67.61 | Professional | 54 · Surgery only | $43.65 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.75 Typical High $13.49 | Professional | 55 · Aftercare only | $8.71 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.89 | $7.76 | $9.12 |
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 $87.10 Median $91.20 Typical High $158.49 | Professional | None | $87.10 | $91.20 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $85.11 Typical High $660.69 | Facility | None | $53.70 | $85.11 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $141.25 | Professional | None | $63.10 | $83.18 | $141.25 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $162.18 | Professional | None | $120.23 | $162.18 | $162.18 |
Geisinger Setting Facility Modifier None Typical Low $53.70 Median $67.61 Typical High $117.49 | Facility | None | $53.70 | $67.61 | $117.49 |
Geisinger Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $158.49 | Professional | None | $54.95 | $91.20 | $158.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $213.80 Median $1,318.26 Typical High $1,445.44 | Facility | None | $213.80 | $1,318.26 | $1,445.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $120.23 | Professional | None | $81.28 | $89.13 | $120.23 |
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 $58.88 Median $77.62 Typical High $91.20 | Professional | None | $58.88 | $77.62 | $91.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $29.51 | $38.90 | $45.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $11.75 | $15.49 | $18.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $58.88 Typical High $67.61 | Professional | 54 · Surgery only | $43.65 | $58.88 | $67.61 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.75 Typical High $13.49 | Professional | 55 · Aftercare only | $8.71 | $11.75 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.89 | $7.76 | $9.12 |
Oscar Health Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $151.36 | Professional | None | $54.95 | $85.11 | $151.36 |
UPMC Health Plan Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $85.11 | Facility | None | $54.95 | $64.57 | $85.11 |
UPMC Health Plan Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $85.11 | Professional | None | $54.95 | $67.61 | $85.11 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $123.03 | Professional | None | $66.07 | $85.11 | $123.03 |
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 $131.83 Median $134.90 Typical High $239.88 | Professional | 50 · Both sides | $131.83 | $134.90 | $239.88 |
Where Pennsylvania sits
The same service costs 3.8 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· 40th of 51
$85.11
AK $263KY $69.18
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.