How much rates vary
Facilitymedian $8,913 · 10th to 90th $603 to $34,674Professionalmedian $398 · 10th to 90th $324 to $661
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 $1,023.29 Median $6,606.93 Typical High $12,302.69 | Facility | None | $1,023.29 | $6,606.93 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $707.95 | Professional | None | $354.81 | $398.11 | $707.95 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $645.65 | Professional | None | $331.13 | $467.74 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $630.96 Typical High $1,174.90 | Facility | None | $457.09 | $630.96 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $660.69 | Professional | None | $316.23 | $371.54 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $489.78 | Professional | None | $446.68 | $446.68 | $489.78 |
Geisinger Setting Facility Modifier None Typical Low $25,118.86 Median $31,622.78 Typical High $56,234.13 | Facility | None | $25,118.86 | $31,622.78 | $56,234.13 |
Geisinger Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $645.65 | Professional | None | $331.13 | $416.87 | $645.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $57,543.99 Median $57,543.99 Typical High $275,422.87 | Facility | None | $57,543.99 | $57,543.99 | $275,422.87 |
Martin's Point Setting Facility Modifier None Typical Low $1,288.25 Median $6,165.95 Typical High $12,589.25 | Facility | None | $1,288.25 | $6,165.95 | $12,589.25 |
Martin's Point Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $707.95 | Professional | None | $354.81 | $398.11 | $707.95 |
UPMC Health Plan Setting Facility Modifier None Typical Low $323.59 Median $371.54 Typical High $371.54 | Facility | None | $323.59 | $371.54 | $371.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $371.54 | Professional | None | $323.59 | $338.84 | $371.54 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $15,135.61 Typical High $34,673.69 | Facility | None | $3,890.45 | $15,135.61 | $34,673.69 |
United Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $691.83 | Professional | None | $302.00 | $426.58 | $691.83 |
10 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 $177.83 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $70.79 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $60.26 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $177.83 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $70.79 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $60.26 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $39.81 |
Where Pennsylvania sits
The same service costs 45.0 times more in New Mexico 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
NM $44,130MT $980
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.