How much rates vary
Facilitymedian $1,047 · 10th to 90th $234 to $6,166Professionalmedian $288 · 10th to 90th $79 to $468
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 $302.00 Median $1,995.26 Typical High $7,943.28 | Facility | None | $302.00 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $208.93 Typical High $346.74 | Professional | None | $74.13 | $208.93 | $346.74 |
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 $288.40 Median $302.00 Typical High $549.54 | Professional | None | $288.40 | $302.00 | $549.54 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $446.68 Typical High $812.83 | Professional | 50 · Both sides | $436.52 | $446.68 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $208.93 Typical High $416.87 | Professional | None | $75.86 | $208.93 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $575.44 | Professional | None | $446.68 | $537.03 | $575.44 |
Geisinger Setting Professional Modifier None Typical Low $91.20 Median $316.23 Typical High $575.44 | Professional | None | $91.20 | $316.23 | $575.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.50 Median $0.50 Typical High $13,182.57 | Facility | None | $0.50 | $0.50 | $13,182.57 |
Martin's Point Setting Facility Modifier None Typical Low $346.74 Median $1,819.70 Typical High $6,606.93 | Facility | None | $346.74 | $1,819.70 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $74.13 Median $208.93 Typical High $346.74 | Professional | None | $74.13 | $208.93 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $478.63 | Professional | None | $398.11 | $446.68 | $478.63 |
UPMC Health Plan Setting Facility Modifier None Typical Low $186.21 Median $309.03 Typical High $446.68 | Facility | None | $186.21 | $309.03 | $446.68 |
UPMC Health Plan Setting Professional Modifier None Typical Low $79.43 Median $295.12 Typical High $446.68 | Professional | None | $79.43 | $295.12 | $446.68 |
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 $85.11 Median $223.87 Typical High $467.74 | Professional | None | $85.11 | $223.87 | $467.74 |
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 $38.02 Median $66.07 Typical High $173.78 | Professional | 52 · Reduced service | $38.02 | $66.07 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $26.92 Typical High $69.18 | Professional | 53 · Discontinued | $15.14 | $26.92 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $100.00 Typical High $257.04 | Professional | 54 · Surgery only | $57.54 | $100.00 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $19.95 Typical High $51.29 | Professional | 55 · Aftercare only | $11.22 | $19.95 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $13.49 Typical High $34.67 | Professional | 56 · Pre-op care only | $7.59 | $13.49 | $34.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $66.07 Typical High $173.78 | Professional | 52 · Reduced service | $37.15 | $66.07 | $173.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $26.92 Typical High $69.18 | Professional | 53 · Discontinued | $14.79 | $26.92 | $69.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $100.00 Typical High $257.04 | Professional | 54 · Surgery only | $56.23 | $100.00 | $257.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $19.95 Typical High $51.29 | Professional | 55 · Aftercare only | $11.22 | $19.95 | $51.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $13.49 Typical High $34.67 | Professional | 56 · Pre-op care only | $7.41 | $13.49 | $34.67 |
Where Pennsylvania sits
The same service costs 4.2 times more in Washington 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· 15th of 51
$288
WA $447VA $107
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.