How much rates vary
Facilitymedian $209 · 10th to 90th $78 to $3,631Professionalmedian $234 · 10th to 90th $148 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 $229.09 Median $2,818.38 Typical High $8,511.38 | Facility | None | $229.09 | $2,818.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $281.84 | Professional | None | $141.25 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $102.33 Typical High $141.25 | Professional | 52 · Reduced service | $70.79 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $28.18 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $208.93 | Professional | 54 · Surgery only | $107.15 | $154.88 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $41.69 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $28.18 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $169.82 Typical High $316.23 | Facility | None | $50.12 | $169.82 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $398.11 | Professional | None | $151.36 | $239.88 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $549.54 | Professional | None | $407.38 | $549.54 | $549.54 |
Geisinger Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $323.59 | Facility | None | $147.91 | $186.21 | $323.59 |
Geisinger Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $524.81 | Professional | None | $199.53 | $323.59 | $524.81 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,584.89 | Facility | None | $1,412.54 | $1,412.54 | $1,584.89 |
Martin's Point Setting Facility Modifier None Typical Low $229.09 Median $2,818.38 Typical High $8,511.38 | Facility | None | $229.09 | $2,818.38 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $281.84 | Professional | None | $141.25 | $239.88 | $281.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $102.33 Typical High $141.25 | Professional | 52 · Reduced service | $70.79 | $102.33 | $141.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $28.18 | $41.69 | $56.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $208.93 | Professional | 54 · Surgery only | $107.15 | $154.88 | $208.93 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $41.69 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $41.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $28.18 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $478.63 | Professional | None | $218.78 | $218.78 | $478.63 |
UPMC Health Plan Setting Facility Modifier None Typical Low $144.54 Median $1,288.25 Typical High $3,548.13 | Facility | None | $144.54 | $1,288.25 | $3,548.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $263.03 | Professional | None | $144.54 | $199.53 | $263.03 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $338.84 | Professional | None | $158.49 | $229.09 | $338.84 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | GC · Resident with teaching physician | $144.54 | $144.54 | $144.54 |
Where Pennsylvania sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 42nd of 51
$234
AK $661MD $182
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.