How much rates vary
Facilitymedian $398 · 10th to 90th $65 to $2,455Professionalmedian $95 · 10th to 90th $56 to $158
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 $61.66 Median $478.63 Typical High $6,025.60 | Facility | None | $61.66 | $478.63 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $109.65 | Professional | None | $53.70 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $26.92 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.98 Typical High $20.89 | Professional | 53 · Discontinued | $10.72 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $63.10 Typical High $77.62 | Professional | 54 · Surgery only | $39.81 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $7.94 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.37 | $8.51 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $177.83 | Professional | None | $85.11 | $97.72 | $177.83 |
AmeriHealth Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $4,168.69 | Facility | None | $524.81 | $707.95 | $4,168.69 |
AmeriHealth Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $112.20 | Professional | None | $51.29 | $104.71 | $112.20 |
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 $97.72 Median $100.00 Typical High $177.83 | Professional | None | $97.72 | $100.00 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $102.33 Typical High $691.83 | Facility | None | $63.10 | $102.33 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $147.91 | Professional | None | $57.54 | $93.33 | $147.91 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $177.83 | Professional | None | $134.90 | $177.83 | $177.83 |
Geisinger Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $134.90 | Facility | None | $61.66 | $77.62 | $134.90 |
Geisinger Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $186.21 | Professional | None | $87.10 | $123.03 | $186.21 |
Highmark BCBS Setting Facility Modifier None Typical Low $275.42 Median $794.33 Typical High $1,380.38 | Facility | None | $275.42 | $794.33 | $1,380.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $162.18 | Professional | None | $102.33 | $117.49 | $162.18 |
Independence Blue Cross Setting Facility Modifier None Typical Low $426.58 Median $691.83 Typical High $3,981.07 | Facility | None | $426.58 | $691.83 | $3,981.07 |
Independence Blue Cross Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $112.20 | Professional | None | $51.29 | $104.71 | $112.20 |
Martin's Point Setting Facility Modifier None Typical Low $70.79 Median $537.03 Typical High $5,754.40 | Facility | None | $70.79 | $537.03 | $5,754.40 |
Martin's Point Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $102.33 | Professional | None | $53.70 | $89.13 | $102.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $41.69 Typical High $51.29 | Professional | 52 · Reduced service | $26.92 | $41.69 | $51.29 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.98 Typical High $20.89 | Professional | 53 · Discontinued | $10.72 | $16.98 | $20.89 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $63.10 Typical High $77.62 | Professional | 54 · Surgery only | $39.81 | $63.10 | $77.62 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $7.94 | $12.59 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.32 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.37 | $8.32 | $10.23 |
Oscar Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | None | $102.33 | $102.33 | $117.49 |
UPMC Health Plan Setting Facility Modifier None Typical Low $58.88 Median $537.03 Typical High $1,047.13 | Facility | None | $58.88 | $537.03 | $1,047.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $100.00 | Professional | None | $58.88 | $97.72 | $100.00 |
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 $61.66 Median $93.33 Typical High $128.82 | Professional | None | $61.66 | $93.33 | $128.82 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $239.88 Typical High $295.12 | Professional | 50 · Both sides | $147.91 | $239.88 | $295.12 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $169.82 Typical High $263.03 | Professional | 50 · Both sides | $144.54 | $169.82 | $263.03 |
Highmark BCBS Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $181.97 Typical High $239.88 | Professional | 50 · Both sides | $165.96 | $181.97 | $239.88 |
Where Pennsylvania sits
The same service costs 3.7 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· 33rd of 51
$97.72
AK $275KY $74.13
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.