How much rates vary
Facilitymedian $1,000 · 10th to 90th $324 to $5,012Professionalmedian $251 · 10th to 90th $166 to $447
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 $194.98 Median $2,570.40 Typical High $8,511.38 | Facility | None | $194.98 | $2,570.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $380.19 | Professional | None | $165.96 | $239.88 | $380.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $501.19 | Professional | None | $251.19 | $398.11 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $794.33 Typical High $1,412.54 | Facility | None | $338.84 | $794.33 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $426.58 | Professional | None | $165.96 | $263.03 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | None | $426.58 | $426.58 | $446.68 |
Geisinger Setting Facility Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,778.28 | Facility | None | $812.83 | $1,023.29 | $1,778.28 |
Geisinger Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $549.54 | Professional | None | $213.80 | $338.84 | $549.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $6,309.57 | Facility | None | $707.95 | $1,995.26 | $6,309.57 |
Martin's Point Setting Facility Modifier None Typical Low $194.98 Median $2,454.71 Typical High $8,317.64 | Facility | None | $194.98 | $2,454.71 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $380.19 | Professional | None | $162.18 | $239.88 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $676.08 | Professional | None | $295.12 | $338.84 | $676.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $239.88 Median $812.83 Typical High $1,862.09 | Facility | None | $239.88 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $371.54 | Professional | None | $162.18 | $239.88 | $371.54 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,890.45 | Facility | None | $416.87 | $724.44 | $3,890.45 |
United Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $426.58 | Professional | None | $154.88 | $239.88 | $426.58 |
12 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 $79.43 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $79.43 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $44.67 Typical High $53.70 | Professional | 53 · Discontinued | $31.62 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $120.23 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.39 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.85 | $22.39 | $26.92 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 50 · Both sides | $602.56 | $602.56 | $602.56 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $602.56 Typical High $758.58 | Professional | 50 · Both sides | $380.19 | $602.56 | $758.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $79.43 | $112.20 | $134.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $44.67 Typical High $53.70 | Professional | 53 · Discontinued | $31.62 | $44.67 | $53.70 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $120.23 | $169.82 | $204.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $40.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.39 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.85 | $22.39 | $26.92 |
Where Pennsylvania sits
The same service costs 3.1 times more in Alaska than in New York. 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· 47th of 51
$269
AK $794NY $257
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.