How much rates vary
Facilitymedian $2,291 · 10th to 90th $617 to $6,310Professionalmedian $832 · 10th to 90th $724 to $1,445
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 $741.31 Median $2,344.23 Typical High $8,317.64 | Facility | None | $741.31 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $831.76 | Professional | None | $724.44 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $389.05 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $83.18 |
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 $794.33 Median $831.76 Typical High $1,621.81 | Professional | None | $794.33 | $831.76 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $2,089.30 | Facility | None | $446.68 | $645.65 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,819.70 | Professional | None | $758.58 | $851.14 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | None | $870.96 | $1,202.26 | $1,202.26 |
Geisinger Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,862.09 | Professional | None | $707.95 | $954.99 | $1,862.09 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $7,244.36 | Facility | None | $758.58 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $831.76 | Professional | None | $724.44 | $776.25 | $831.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $389.05 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $389.05 | $407.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $154.88 | $165.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $575.44 | $616.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $123.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $83.18 |
Oscar Health Setting Professional Modifier None Typical Low $12.88 Median $1,096.48 Typical High $1,737.80 | Professional | None | $12.88 | $1,096.48 | $1,737.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $933.25 | Facility | None | $776.25 | $933.25 | $933.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | None | $776.25 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,090.30 Typical High $6,165.95 | Facility | None | $1,698.24 | $3,090.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,348.96 | Professional | None | $741.31 | $891.25 | $1,348.96 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | XU · Unusual separate service | $2,454.71 | $2,454.71 | $2,454.71 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 62 · Two surgeons | $812.83 | $812.83 | $812.83 |
Where Pennsylvania sits
The same service costs 4.6 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.
Physician feeFacility fee
AK $9,843KY $2,122
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.