How much rates vary
Facilitymedian $447 · 10th to 90th $100 to $3,802Professionalmedian $263 · 10th to 90th $132 to $468
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 $302.00 Median $2,818.38 Typical High $8,511.38 | Facility | None | $302.00 | $2,818.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $302.00 | Professional | None | $128.82 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $91.20 Typical High $151.36 | Professional | 52 · Reduced service | $64.57 | $91.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $36.31 Typical High $60.26 | Professional | 53 · Discontinued | $25.70 | $36.31 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $134.90 Typical High $223.87 | Professional | 54 · Surgery only | $95.50 | $134.90 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $26.92 Typical High $44.67 | Professional | 55 · Aftercare only | $19.50 | $26.92 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.88 | $18.20 | $30.20 |
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 $263.03 Median $416.87 Typical High $501.19 | Professional | None | $263.03 | $416.87 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $794.33 | Facility | None | $229.09 | $436.52 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $436.52 | Professional | None | $131.83 | $251.19 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | None | $446.68 | $446.68 | $467.74 |
Geisinger Setting Facility Modifier None Typical Low $208.93 Median $263.03 Typical High $457.09 | Facility | None | $208.93 | $263.03 | $457.09 |
Geisinger Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $457.09 | Professional | None | $154.88 | $288.40 | $457.09 |
Martin's Point Setting Facility Modifier None Typical Low $575.44 Median $2,630.27 Typical High $8,317.64 | Facility | None | $575.44 | $2,630.27 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $302.00 | Professional | None | $128.82 | $251.19 | $302.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $91.20 Typical High $151.36 | Professional | 52 · Reduced service | $64.57 | $91.20 | $151.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $36.31 Typical High $60.26 | Professional | 53 · Discontinued | $25.70 | $36.31 | $60.26 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $134.90 Typical High $223.87 | Professional | 54 · Surgery only | $95.50 | $134.90 | $223.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $26.92 Typical High $44.67 | Professional | 55 · Aftercare only | $19.50 | $26.92 | $44.67 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.88 | $18.20 | $30.20 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $524.81 | Professional | None | $223.87 | $269.15 | $524.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $173.78 Median $1,071.52 Typical High $2,511.89 | Facility | None | $173.78 | $1,071.52 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $269.15 | Professional | None | $131.83 | $263.03 | $269.15 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,318.26 | Facility | None | $77.62 | $158.49 | $1,318.26 |
United Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $416.87 | Professional | None | $120.23 | $229.09 | $416.87 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $630.96 Typical High $758.58 | Professional | 50 · Both sides | $398.11 | $630.96 | $758.58 |
Where Pennsylvania sits
The same service costs 3.2 times more in Wisconsin 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· 38th of 51
$263
WI $646KY $204
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.