How much rates vary
Facilitymedian $120 · 10th to 90th $63 to $1,479Professionalmedian $83 · 10th to 90th $58 to $138
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 $56.23 Median $79.43 Typical High $147.91 | Facility | None | $56.23 | $79.43 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $100.00 | Professional | None | $54.95 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $27.54 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.14 Typical High $17.78 | Professional | 53 · Discontinued | $10.96 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $8.13 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.50 | $7.59 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | None | $93.33 | $93.33 | $128.82 |
AmeriHealth Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $2,238.72 | Facility | None | $575.44 | $1,412.54 | $2,238.72 |
AmeriHealth Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | None | $91.20 | $91.20 | $104.71 |
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 $89.13 Median $93.33 Typical High $162.18 | Professional | None | $89.13 | $93.33 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $83.18 Typical High $138.04 | Facility | None | $50.12 | $83.18 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $141.25 | Professional | None | $57.54 | $81.28 | $141.25 |
Emblem Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | None | $125.89 | $169.82 | $169.82 |
Geisinger Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $144.54 | Facility | None | $66.07 | $83.18 | $144.54 |
Geisinger Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $177.83 | Professional | None | $72.44 | $104.71 | $177.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $208.93 Median $691.83 Typical High $1,548.82 | Facility | None | $208.93 | $691.83 | $1,548.82 |
Highmark BCBS Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $117.49 | Professional | None | $89.13 | $100.00 | $117.49 |
Independence Blue Cross Setting Facility Modifier None Typical Low $323.59 Median $1,023.29 Typical High $2,238.72 | Facility | None | $323.59 | $1,023.29 | $2,238.72 |
Independence Blue Cross Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | None | $91.20 | $91.20 | $104.71 |
Martin's Point Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $147.91 | Facility | None | $63.10 | $89.13 | $147.91 |
Martin's Point Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $95.50 | Professional | None | $54.95 | $75.86 | $95.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $27.54 | $38.02 | $44.67 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.14 Typical High $17.78 | Professional | 53 · Discontinued | $10.96 | $15.14 | $17.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $8.13 | $11.48 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.50 | $7.59 | $8.91 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $169.82 | Professional | None | $89.13 | $89.13 | $169.82 |
UPMC Health Plan Setting Facility Modifier None Typical Low $61.66 Median $141.25 Typical High $323.59 | Facility | None | $61.66 | $141.25 | $323.59 |
UPMC Health Plan Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $85.11 | Professional | None | $61.66 | $77.62 | $85.11 |
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 $60.26 Median $81.28 Typical High $117.49 | Professional | None | $60.26 | $81.28 | $117.49 |
4 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 |
|---|---|---|---|---|---|
AmeriHealth Setting Professional Modifier 58 · Staged procedure Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 58 · Staged procedure | $91.20 | $91.20 | $102.33 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $138.04 Typical High $245.47 | Professional | 50 · Both sides | $134.90 | $138.04 | $245.47 |
Highmark BCBS Setting Professional Modifier 58 · Staged procedure Typical Low $77.62 Median $93.33 Typical High $109.65 | Professional | 58 · Staged procedure | $77.62 | $93.33 | $109.65 |
Independence Blue Cross Setting Professional Modifier 58 · Staged procedure Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 58 · Staged procedure | $91.20 | $91.20 | $102.33 |
Where Pennsylvania sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 40th of 51
$83.18
AK $257KY $69.18
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.