How much rates vary
Facilitymedian $3,981 · 10th to 90th $631 to $9,120Professionalmedian $2,344 · 10th to 90th $162 to $4,074
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 $831.76 Median $5,754.40 Typical High $10,232.93 | Facility | None | $831.76 | $5,754.40 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $1,513.56 Typical High $2,884.03 | Professional | None | $162.18 | $1,513.56 | $2,884.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $114.82 Typical High $1,445.44 | Professional | 52 · Reduced service | $81.28 | $114.82 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $45.71 Typical High $588.84 | Professional | 53 · Discontinued | $32.36 | $45.71 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $2,187.76 | Professional | 54 · Surgery only | $120.23 | $169.82 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $436.52 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.91 Typical High $288.40 | Professional | 56 · Pre-op care only | $16.22 | $22.91 | $288.40 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $15,848.93 Typical High $56,234.13 | Facility | None | $3,981.07 | $15,848.93 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $2,290.87 Median $2,344.23 Typical High $6,309.57 | Professional | None | $2,290.87 | $2,344.23 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,981.07 Typical High $6,760.83 | Facility | None | $501.19 | $3,981.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $4,073.80 | Professional | None | $165.96 | $354.81 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,073.80 | Professional | None | $3,981.07 | $3,981.07 | $4,073.80 |
Geisinger Setting Facility Modifier None Typical Low $4,073.80 Median $5,128.61 Typical High $8,912.51 | Facility | None | $4,073.80 | $5,128.61 | $8,912.51 |
Geisinger Setting Professional Modifier None Typical Low $181.97 Median $2,951.21 Typical High $3,981.07 | Professional | None | $181.97 | $2,951.21 | $3,981.07 |
Highmark BCBS Setting Facility Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Facility | None | $15,135.61 | $15,135.61 | $15,135.61 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $5,370.32 Typical High $10,964.78 | Facility | None | $1,023.29 | $5,370.32 | $10,964.78 |
Martin's Point Setting Professional Modifier None Typical Low $162.18 Median $1,513.56 Typical High $2,884.03 | Professional | None | $162.18 | $1,513.56 | $2,884.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $114.82 Typical High $1,445.44 | Professional | 52 · Reduced service | $81.28 | $114.82 | $1,445.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $45.71 Typical High $588.84 | Professional | 53 · Discontinued | $32.36 | $45.71 | $588.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $2,187.76 | Professional | 54 · Surgery only | $120.23 | $169.82 | $2,187.76 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $436.52 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $436.52 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.91 Typical High $288.40 | Professional | 56 · Pre-op care only | $16.22 | $22.91 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,471.29 | Professional | None | $2,818.38 | $3,019.95 | $10,471.29 |
UPMC Health Plan Setting Facility Modifier None Typical Low $165.96 Median $181.97 Typical High $3,019.95 | Facility | None | $165.96 | $181.97 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $165.96 Median $2,398.83 Typical High $3,019.95 | Professional | None | $165.96 | $2,398.83 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $158.49 Median $2,089.30 Typical High $4,897.79 | Professional | None | $158.49 | $2,089.30 | $4,897.79 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 51 · Multiple procedures | $114.82 | $114.82 | $114.82 |
Where Pennsylvania sits
The same service costs 33.1 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· 29th of 51
$2,344
AK $5,495KY $166
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.