How much rates vary
Facilitymedian $240 · 10th to 90th $60 to $3,981Professionalmedian $123 · 10th to 90th $55 to $234
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 $61.66 Median $537.03 Typical High $6,165.95 | Facility | None | $61.66 | $537.03 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $97.72 Typical High $199.53 | Professional | None | $54.95 | $97.72 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
AmeriHealth Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
AmeriHealth Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $213.80 | Professional | None | $147.91 | $165.96 | $213.80 |
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 $151.36 Median $223.87 Typical High $263.03 | Professional | None | $151.36 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $239.88 | Professional | None | $56.23 | $97.72 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $281.84 | Professional | None | $275.42 | $275.42 | $281.84 |
Geisinger Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $263.03 | Professional | None | $66.07 | $154.88 | $263.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $204.17 Median $457.09 Typical High $851.14 | Facility | None | $204.17 | $457.09 | $851.14 |
Independence Blue Cross Setting Facility Modifier None Typical Low $758.58 Median $5,754.40 Typical High $12,022.64 | Facility | None | $758.58 | $5,754.40 | $12,022.64 |
Independence Blue Cross Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | None | $165.96 | $165.96 | $190.55 |
Martin's Point Setting Facility Modifier None Typical Low $66.07 Median $660.69 Typical High $6,025.60 | Facility | None | $66.07 | $660.69 | $6,025.60 |
Martin's Point Setting Professional Modifier None Typical Low $54.95 Median $97.72 Typical High $199.53 | Professional | None | $54.95 | $97.72 | $199.53 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $275.42 | Professional | None | $134.90 | $141.25 | $275.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $70.79 Median $199.53 Typical High $436.52 | Facility | None | $70.79 | $199.53 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $56.23 Median $109.65 Typical High $151.36 | Professional | None | $56.23 | $109.65 | $151.36 |
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 $52.48 Median $114.82 Typical High $229.09 | Professional | None | $52.48 | $114.82 | $229.09 |
11 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 $27.54 Median $38.90 Typical High $87.10 | Professional | 52 · Reduced service | $27.54 | $38.90 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.49 Typical High $34.67 | Professional | 53 · Discontinued | $10.96 | $15.49 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $57.54 Typical High $128.82 | Professional | 54 · Surgery only | $40.74 | $57.54 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.88 Typical High $25.70 | Professional | 55 · Aftercare only | $8.13 | $12.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.76 Typical High $17.38 | Professional | 56 · Pre-op care only | $5.50 | $7.76 | $17.38 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $316.23 Typical High $398.11 | Professional | 50 · Both sides | $229.09 | $316.23 | $398.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $38.90 Typical High $87.10 | Professional | 52 · Reduced service | $27.54 | $38.90 | $87.10 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.49 Typical High $34.67 | Professional | 53 · Discontinued | $10.96 | $15.49 | $34.67 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $57.54 Typical High $128.82 | Professional | 54 · Surgery only | $40.74 | $57.54 | $128.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.88 Typical High $25.70 | Professional | 55 · Aftercare only | $8.13 | $12.88 | $25.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.76 Typical High $17.38 | Professional | 56 · Pre-op care only | $5.50 | $7.76 | $17.38 |
Where Pennsylvania sits
The same service costs 4.0 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· 26th of 51
$135
AK $316KY $79.43
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.