How much rates vary
Facilitymedian $479 · 10th to 90th $91 to $5,495Professionalmedian $186 · 10th to 90th $71 to $324
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 $81.28 Median $660.69 Typical High $6,165.95 | Facility | None | $81.28 | $660.69 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $213.80 | Professional | None | $67.61 | $154.88 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $77.62 | Professional | None | $63.10 | $63.10 | $77.62 |
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 $186.21 Median $190.55 Typical High $346.74 | Professional | None | $186.21 | $190.55 | $346.74 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $288.40 Typical High $524.81 | Professional | 50 · Both sides | $275.42 | $288.40 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $162.18 Typical High $288.40 | Professional | None | $70.79 | $162.18 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $331.13 | Professional | None | $263.03 | $309.03 | $331.13 |
Geisinger Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $389.05 | Professional | None | $85.11 | $199.53 | $389.05 |
Highmark BCBS Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $758.58 | Facility | None | $309.03 | $416.87 | $758.58 |
Highmark BCBS Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $229.09 | Professional | None | $70.79 | $85.11 | $229.09 |
Martin's Point Setting Facility Modifier None Typical Low $87.10 Median $812.83 Typical High $6,025.60 | Facility | None | $87.10 | $812.83 | $6,025.60 |
Martin's Point Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $213.80 | Professional | None | $66.07 | $147.91 | $213.80 |
Oscar Health Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $446.68 | Professional | None | $338.84 | $354.81 | $446.68 |
UPMC Health Plan Setting Facility Modifier None Typical Low $134.90 Median $309.03 Typical High $741.31 | Facility | None | $134.90 | $309.03 | $741.31 |
UPMC Health Plan Setting Professional Modifier None Typical Low $70.79 Median $186.21 Typical High $741.31 | Professional | None | $70.79 | $186.21 | $741.31 |
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 $75.86 Median $158.49 Typical High $338.84 | Professional | None | $75.86 | $158.49 | $338.84 |
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 $33.88 Median $58.88 Typical High $104.71 | Professional | 52 · Reduced service | $33.88 | $58.88 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.44 Typical High $42.66 | Professional | 53 · Discontinued | $13.49 | $23.44 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $87.10 Typical High $158.49 | Professional | 54 · Surgery only | $51.29 | $87.10 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.38 Typical High $31.62 | Professional | 55 · Aftercare only | $10.23 | $17.38 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.75 Typical High $21.38 | Professional | 56 · Pre-op care only | $6.76 | $11.75 | $21.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $58.88 Typical High $104.71 | Professional | 52 · Reduced service | $33.11 | $58.88 | $104.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $23.44 Typical High $42.66 | Professional | 53 · Discontinued | $13.18 | $23.44 | $42.66 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $87.10 Typical High $158.49 | Professional | 54 · Surgery only | $50.12 | $87.10 | $158.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.38 Typical High $31.62 | Professional | 55 · Aftercare only | $10.00 | $17.38 | $31.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.75 Typical High $21.38 | Professional | 56 · Pre-op care only | $6.61 | $11.75 | $21.38 |
Where Pennsylvania sits
The same service costs 3.8 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· 19th of 51
$186
AK $363VA $95.50
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.