How much rates vary
Facilitymedian $363 · 10th to 90th $78 to $3,981Professionalmedian $158 · 10th to 90th $74 to $288
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 $89.13 Median $660.69 Typical High $6,165.95 | Facility | None | $89.13 | $660.69 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $190.55 | Professional | None | $74.13 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $37.15 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $26.30 Typical High $33.88 | Professional | 53 · Discontinued | $14.79 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $97.72 Typical High $128.82 | Professional | 54 · Surgery only | $54.95 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.50 Typical High $25.70 | Professional | 55 · Aftercare only | $10.96 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.41 | $13.18 | $16.98 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $269.15 | Professional | None | $97.72 | $169.82 | $269.15 |
AmeriHealth Setting Facility Modifier None Typical Low $549.54 Median $707.95 Typical High $10,715.19 | Facility | None | $549.54 | $707.95 | $10,715.19 |
AmeriHealth Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $190.55 | Professional | None | $85.11 | $147.91 | $190.55 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $56,234.13 | Facility | None | $3,981.07 | $5,011.87 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $309.03 | Professional | None | $158.49 | $165.96 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $446.68 | Facility | None | $50.12 | $66.07 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $154.88 Typical High $302.00 | Professional | None | $61.66 | $154.88 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | None | $229.09 | $295.12 | $295.12 |
Geisinger Setting Professional Modifier None Typical Low $91.20 Median $218.78 Typical High $436.52 | Professional | None | $91.20 | $218.78 | $436.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $489.78 Median $977.24 Typical High $2,754.23 | Facility | None | $489.78 | $977.24 | $2,754.23 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $316.23 | Professional | None | $123.03 | $194.98 | $316.23 |
Independence Blue Cross Setting Facility Modifier None Typical Low $457.09 Median $707.95 Typical High $8,912.51 | Facility | None | $457.09 | $707.95 | $8,912.51 |
Independence Blue Cross Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $194.98 | Professional | None | $85.11 | $97.72 | $194.98 |
Martin's Point Setting Facility Modifier None Typical Low $83.18 Median $812.83 Typical High $5,888.44 | Facility | None | $83.18 | $812.83 | $5,888.44 |
Martin's Point Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $186.21 | Professional | None | $74.13 | $144.54 | $186.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $37.15 | $66.07 | $85.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $26.30 Typical High $33.88 | Professional | 53 · Discontinued | $14.79 | $26.30 | $33.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $97.72 Typical High $128.82 | Professional | 54 · Surgery only | $54.95 | $97.72 | $128.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.50 Typical High $25.70 | Professional | 55 · Aftercare only | $10.96 | $19.50 | $25.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.41 | $13.18 | $16.98 |
Oscar Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $870.96 | Facility | None | $831.76 | $831.76 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $575.44 Typical High $616.60 | Professional | None | $288.40 | $575.44 | $616.60 |
UPMC Health Plan Setting Facility Modifier None Typical Low $100.00 Median $190.55 Typical High $363.08 | Facility | None | $100.00 | $190.55 | $363.08 |
UPMC Health Plan Setting Professional Modifier None Typical Low $81.28 Median $190.55 Typical High $363.08 | Professional | None | $81.28 | $190.55 | $363.08 |
United Setting Facility Modifier None Typical Low $70.79 Median $144.54 Typical High $1,230.27 | Facility | None | $70.79 | $144.54 | $1,230.27 |
United Setting Professional Modifier None Typical Low $72.44 Median $151.36 Typical High $223.87 | Professional | None | $72.44 | $151.36 | $223.87 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | 50 · Both sides | $208.93 | $245.47 | $245.47 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $251.19 Typical High $467.74 | Professional | 50 · Both sides | $239.88 | $251.19 | $467.74 |
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· 27th of 51
$158
AK $417VA $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.