How much rates vary
Facilitymedian $437 · 10th to 90th $46 to $1,698Professionalmedian $63 · 10th to 90th $43 to $107
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 $53.70 Median $645.65 Typical High $4,073.80 | Facility | None | $53.70 | $645.65 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $81.28 | Professional | None | $40.74 | $57.54 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $117.49 | Professional | None | $57.54 | $77.62 | $117.49 |
AmeriHealth Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $1,698.24 | Facility | None | $39.81 | $39.81 | $1,698.24 |
AmeriHealth Setting Professional Modifier None Typical Low $33.88 Median $57.54 Typical High $70.79 | Professional | None | $33.88 | $57.54 | $70.79 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $8,709.64 | Facility | None | $1,202.26 | $1,258.93 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $125.89 | Professional | None | $64.57 | $91.20 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $245.47 Typical High $549.54 | Facility | None | $41.69 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $104.71 | Professional | None | $43.65 | $61.66 | $104.71 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $141.25 | Professional | None | $89.13 | $117.49 | $141.25 |
Geisinger Setting Facility Modifier None Typical Low $38.02 Median $46.77 Typical High $83.18 | Facility | None | $38.02 | $46.77 | $83.18 |
Geisinger Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $144.54 | Professional | None | $61.66 | $85.11 | $144.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $60.26 Median $660.69 Typical High $1,202.26 | Facility | None | $60.26 | $660.69 | $1,202.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $109.65 | Professional | None | $60.26 | $81.28 | $109.65 |
Independence Blue Cross Setting Facility Modifier None Typical Low $39.81 Median $575.44 Typical High $1,230.27 | Facility | None | $39.81 | $575.44 | $1,230.27 |
Independence Blue Cross Setting Professional Modifier None Typical Low $33.88 Median $57.54 Typical High $72.44 | Professional | None | $33.88 | $57.54 | $72.44 |
Martin's Point Setting Facility Modifier None Typical Low $57.54 Median $660.69 Typical High $3,630.78 | Facility | None | $57.54 | $660.69 | $3,630.78 |
Martin's Point Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $81.28 | Professional | None | $40.74 | $57.54 | $81.28 |
Oscar Health Setting Facility Modifier None Typical Low $46.77 Median $478.63 Typical High $1,778.28 | Facility | None | $46.77 | $478.63 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $154.88 | Professional | None | $67.61 | $67.61 | $154.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $37.15 Median $57.54 Typical High $74.13 | Facility | None | $37.15 | $57.54 | $74.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $74.13 | Professional | None | $43.65 | $63.10 | $74.13 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,348.96 | Facility | None | $77.62 | $158.49 | $1,348.96 |
United Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $91.20 | Professional | None | $46.77 | $61.66 | $91.20 |
19 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 $20.42 Median $28.84 Typical High $33.88 | Professional | 52 · Reduced service | $20.42 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $11.48 Typical High $13.49 | Professional | 53 · Discontinued | $8.13 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $43.65 Typical High $50.12 | Professional | 54 · Surgery only | $30.20 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $8.71 Typical High $10.00 | Professional | 55 · Aftercare only | $6.17 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.75 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.07 | $5.75 | $6.76 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $97.72 Median $123.03 Typical High $190.55 | Professional | 50 · Both sides | $97.72 | $123.03 | $190.55 |
AmeriHealth Setting Professional Modifier 58 · Staged procedure Typical Low $33.88 Median $67.61 Typical High $70.79 | Professional | 58 · Staged procedure | $33.88 | $67.61 | $70.79 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | 50 · Both sides | $95.50 | $138.04 | $190.55 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $67.61 Median $1,202.26 Typical High $2,238.72 | Facility | 50 · Both sides | $67.61 | $1,202.26 | $2,238.72 |
Highmark BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $120.23 Typical High $154.88 | Professional | 50 · Both sides | $107.15 | $120.23 | $154.88 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $53.70 Median $70.79 Typical High $83.18 | Professional | 59 · Distinct service | $53.70 | $70.79 | $83.18 |
Highmark BCBS Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $61.66 Median $81.28 Typical High $95.50 | Professional | 79 · Unrelated procedure after surgery | $61.66 | $81.28 | $95.50 |
Highmark BCBS Setting Professional Modifier XS · Separate structure Typical Low $57.54 Median $79.43 Typical High $87.10 | Professional | XS · Separate structure | $57.54 | $79.43 | $87.10 |
Independence Blue Cross Setting Professional Modifier 58 · Staged procedure Typical Low $33.88 Median $67.61 Typical High $72.44 | Professional | 58 · Staged procedure | $33.88 | $67.61 | $72.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $28.18 Typical High $33.88 | Professional | 52 · Reduced service | $20.42 | $28.18 | $33.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $11.48 Typical High $13.49 | Professional | 53 · Discontinued | $8.13 | $11.48 | $13.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $42.66 Typical High $50.12 | Professional | 54 · Surgery only | $30.20 | $42.66 | $50.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $8.51 Typical High $10.00 | Professional | 55 · Aftercare only | $6.17 | $8.51 | $10.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.75 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.07 | $5.75 | $6.76 |
Where Pennsylvania sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 41st of 51
$64.57
AK $224FL $53.70
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.