How much rates vary
Facilitymedian $589 · 10th to 90th $76 to $5,129Professionalmedian $151 · 10th to 90th $49 to $263
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 $54.95 Median $478.63 Typical High $6,025.60 | Facility | None | $54.95 | $478.63 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $131.83 Typical High $181.97 | Professional | None | $46.77 | $131.83 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $151.36 | Professional | None | $69.18 | $72.44 | $151.36 |
AmeriHealth Setting Facility Modifier None Typical Low $562.34 Median $707.95 Typical High $7,413.10 | Facility | None | $562.34 | $707.95 | $7,413.10 |
AmeriHealth Setting Professional Modifier None Typical Low $51.29 Median $173.78 Typical High $181.97 | Professional | None | $51.29 | $173.78 | $181.97 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $288.40 | Professional | None | $151.36 | $158.49 | $288.40 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $239.88 Typical High $436.52 | Professional | 50 · Both sides | $229.09 | $239.88 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $128.82 Typical High $257.04 | Professional | None | $47.86 | $128.82 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $275.42 | Professional | None | $218.78 | $257.04 | $275.42 |
Geisinger Setting Professional Modifier None Typical Low $58.88 Median $169.82 Typical High $323.59 | Professional | None | $58.88 | $169.82 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $1,000.00 | Facility | None | $316.23 | $501.19 | $1,000.00 |
Highmark BCBS Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $186.21 | Professional | None | $47.86 | $60.26 | $186.21 |
Independence Blue Cross Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $7,079.46 | Facility | None | $478.63 | $707.95 | $7,079.46 |
Independence Blue Cross Setting Professional Modifier None Typical Low $51.29 Median $134.90 Typical High $208.93 | Professional | None | $51.29 | $134.90 | $208.93 |
Martin's Point Setting Facility Modifier None Typical Low $58.88 Median $588.84 Typical High $5,754.40 | Facility | None | $58.88 | $588.84 | $5,754.40 |
Martin's Point Setting Professional Modifier None Typical Low $44.67 Median $131.83 Typical High $177.83 | Professional | None | $44.67 | $131.83 | $177.83 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $407.38 | Professional | None | $288.40 | $323.59 | $407.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $123.03 Median $288.40 Typical High $436.52 | Facility | None | $123.03 | $288.40 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $48.98 Median $158.49 Typical High $288.40 | Professional | None | $48.98 | $158.49 | $288.40 |
United Setting Facility Modifier None Typical Low $169.82 Median $524.81 Typical High $3,890.45 | Facility | None | $169.82 | $524.81 | $3,890.45 |
United Setting Professional Modifier None Typical Low $52.48 Median $134.90 Typical High $275.42 | Professional | None | $52.48 | $134.90 | $275.42 |
10 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 $23.44 Median $39.81 Typical High $89.13 | Professional | 52 · Reduced service | $23.44 | $39.81 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $16.22 Typical High $35.48 | Professional | 53 · Discontinued | $9.33 | $16.22 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $60.26 Typical High $134.90 | Professional | 54 · Surgery only | $34.67 | $60.26 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $12.02 Typical High $26.92 | Professional | 55 · Aftercare only | $6.92 | $12.02 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.94 Typical High $17.78 | Professional | 56 · Pre-op care only | $4.68 | $7.94 | $17.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $39.81 Typical High $89.13 | Professional | 52 · Reduced service | $22.91 | $39.81 | $89.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $16.22 Typical High $35.48 | Professional | 53 · Discontinued | $9.12 | $16.22 | $35.48 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $60.26 Typical High $134.90 | Professional | 54 · Surgery only | $33.88 | $60.26 | $134.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $12.02 Typical High $26.92 | Professional | 55 · Aftercare only | $6.76 | $12.02 | $26.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $10.96 Typical High $17.78 | Professional | 56 · Pre-op care only | $4.57 | $10.96 | $17.78 |
Where Pennsylvania sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 16th of 51
$158
AK $257VA $66.07
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.