How much rates vary
Facilitymedian $2,291 · 10th to 90th $661 to $7,586Professionalmedian $776 · 10th to 90th $676 to $1,380
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 $707.95 Median $1,737.80 Typical High $7,244.36 | Facility | None | $707.95 | $1,737.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $831.76 | Professional | None | $676.08 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $371.54 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $588.84 | Professional | 54 · Surgery only | $512.86 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $77.62 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,479.11 | Professional | None | $758.58 | $776.25 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $3,890.45 | Facility | None | $446.68 | $645.65 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,659.59 | Professional | None | $724.44 | $776.25 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,202.26 | Professional | None | $851.14 | $1,202.26 | $1,202.26 |
Geisinger Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,659.59 | Professional | None | $691.83 | $912.01 | $1,659.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,454.71 | Facility | None | $478.63 | $1,513.56 | $2,454.71 |
Highmark BCBS Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Martin's Point Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $6,165.95 | Facility | None | $707.95 | $1,737.80 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $776.25 | Professional | None | $676.08 | $741.31 | $776.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $363.08 | $389.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $144.54 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $588.84 | Professional | 54 · Surgery only | $512.86 | $549.54 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $77.62 |
Oscar Health Setting Professional Modifier None Typical Low $12.88 Median $1,000.00 Typical High $1,584.89 | Professional | None | $12.88 | $1,000.00 | $1,584.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $741.31 Median $4,677.35 Typical High $7,585.78 | Facility | None | $741.31 | $4,677.35 | $7,585.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | None | $741.31 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $6,918.31 | Facility | None | $1,698.24 | $3,162.28 | $6,918.31 |
United Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,258.93 | Professional | None | $707.95 | $831.76 | $1,258.93 |
2 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 59 · Distinct service Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 59 · Distinct service | $630.96 | $630.96 | $630.96 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 62 · Two surgeons | $794.33 | $794.33 | $794.33 |
Where Pennsylvania sits
The same service costs 7.9 times more in Alabama 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.
Physician feeFacility fee
AL $15,682KY $1,997
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.