How much rates vary
Facilitymedian $2,042 · 10th to 90th $550 to $8,318Professionalmedian $195 · 10th to 90th $170 to $363
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 $190.55 Median $3,235.94 Typical High $8,317.64 | Facility | None | $190.55 | $3,235.94 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $269.15 | Professional | None | $169.82 | $190.55 | $269.15 |
AmeriHealth Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $15,135.61 | Facility | None | $1,047.13 | $7,943.28 | $15,135.61 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $389.05 | Professional | None | $181.97 | $288.40 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,621.81 Typical High $2,691.53 | Facility | None | $501.19 | $1,621.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $354.81 | Professional | None | $173.78 | $204.17 | $354.81 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | None | $239.88 | $239.88 | $257.04 |
Geisinger Setting Facility Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,041.74 | $3,630.78 |
Geisinger Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $371.54 | Professional | None | $154.88 | $223.87 | $371.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,290.87 Typical High $12,589.25 | Facility | None | $1,047.13 | $2,290.87 | $12,589.25 |
Independence Blue Cross Setting Facility Modifier None Typical Low $1,148.15 Median $7,762.47 Typical High $13,803.84 | Facility | None | $1,148.15 | $7,762.47 | $13,803.84 |
Martin's Point Setting Facility Modifier None Typical Low $208.93 Median $3,630.78 Typical High $8,317.64 | Facility | None | $208.93 | $3,630.78 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $269.15 | Professional | None | $169.82 | $190.55 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $407.38 | Professional | None | $204.17 | $275.42 | $407.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $177.83 Median $1,737.80 Typical High $3,388.44 | Facility | None | $177.83 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $263.03 | Professional | None | $177.83 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $5,011.87 | Facility | None | $812.83 | $1,318.26 | $5,011.87 |
United Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $363.08 | Professional | None | $154.88 | $194.98 | $363.08 |
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 $85.11 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $25.70 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $19.05 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $436.52 Typical High $588.84 | Professional | 50 · Both sides | $269.15 | $436.52 | $588.84 |
Highmark BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 50 · Both sides | $426.58 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $85.11 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $128.82 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $25.70 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $19.05 |
Where Pennsylvania sits
The same service costs 11.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $6,151MT $545
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.