How much rates vary
Facilitymedian $832 · 10th to 90th $123 to $5,888Professionalmedian $182 · 10th to 90th $65 to $316
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 $79.43 Median $1,584.89 Typical High $6,606.93 | Facility | None | $79.43 | $1,584.89 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $147.91 Typical High $208.93 | Professional | None | $61.66 | $147.91 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $181.97 Median $186.21 Typical High $338.84 | Professional | None | $181.97 | $186.21 | $338.84 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $281.84 Typical High $501.19 | Professional | 50 · Both sides | $269.15 | $281.84 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $158.49 Typical High $281.84 | Professional | None | $63.10 | $158.49 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $331.13 | Professional | None | $257.04 | $309.03 | $331.13 |
Geisinger Setting Professional Modifier None Typical Low $77.62 Median $194.98 Typical High $389.05 | Professional | None | $77.62 | $194.98 | $389.05 |
Highmark BCBS Setting Facility Modifier None Typical Low $208.93 Median $758.58 Typical High $1,479.11 | Facility | None | $208.93 | $758.58 | $1,479.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $239.88 | Professional | None | $72.44 | $74.13 | $239.88 |
Martin's Point Setting Facility Modifier None Typical Low $102.33 Median $1,513.56 Typical High $6,165.95 | Facility | None | $102.33 | $1,513.56 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $61.66 Median $147.91 Typical High $204.17 | Professional | None | $61.66 | $147.91 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $457.09 | Professional | None | $331.13 | $371.54 | $457.09 |
UPMC Health Plan Setting Facility Modifier None Typical Low $138.04 Median $295.12 Typical High $891.25 | Facility | None | $138.04 | $295.12 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $64.57 Median $181.97 Typical High $891.25 | Professional | None | $64.57 | $181.97 | $891.25 |
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 $69.18 Median $158.49 Typical High $331.13 | Professional | None | $69.18 | $158.49 | $331.13 |
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 $30.90 Median $53.70 Typical High $102.33 | Professional | 52 · Reduced service | $30.90 | $53.70 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $21.38 Typical High $40.74 | Professional | 53 · Discontinued | $12.30 | $21.38 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $79.43 Typical High $154.88 | Professional | 54 · Surgery only | $46.77 | $79.43 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.85 Typical High $30.90 | Professional | 55 · Aftercare only | $9.33 | $15.85 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $12.88 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.17 | $12.88 | $20.42 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $53.70 Typical High $102.33 | Professional | 52 · Reduced service | $30.20 | $53.70 | $102.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $21.38 Typical High $40.74 | Professional | 53 · Discontinued | $12.02 | $21.38 | $40.74 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $79.43 Typical High $154.88 | Professional | 54 · Surgery only | $45.71 | $79.43 | $154.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $15.85 Typical High $30.90 | Professional | 55 · Aftercare only | $9.12 | $15.85 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $12.88 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.03 | $12.88 | $20.42 |
Where Pennsylvania sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 19th of 51
$182
NC $302IN $85.11
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.