How much rates vary
Facilitymedian $794 · 10th to 90th $240 to $6,310Professionalmedian $3,020 · 10th to 90th $2,399 to $4,898
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 $831.76 Median $4,897.79 Typical High $8,511.38 | Facility | None | $831.76 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,691.53 | $3,019.95 | $3,019.95 |
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 $2,511.89 Median $4,265.80 Typical High $5,248.07 | Professional | None | $2,511.89 | $4,265.80 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $645.65 Typical High $2,290.87 | Facility | None | $380.19 | $645.65 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $5,128.61 | Professional | None | $2,398.83 | $2,951.21 | $5,128.61 |
Emblem Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,073.80 | Professional | None | $3,630.78 | $3,630.78 | $4,073.80 |
Geisinger Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $5,011.87 | Professional | None | $2,630.27 | $3,388.44 | $5,011.87 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,709.64 | Facility | None | $831.76 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,691.53 | $3,019.95 | $3,019.95 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $2,754.23 Typical High $2,818.38 | Professional | None | $19.95 | $2,754.23 | $2,818.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,454.71 | $2,884.03 | $2,884.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,570.40 | $2,884.03 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,344.23 | $3,388.44 | $5,248.07 |
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 $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,348.96 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,041.74 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $269.15 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,348.96 | $1,513.56 | $1,513.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $537.03 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,041.74 | $2,238.72 | $2,238.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $446.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $269.15 | $302.00 | $302.00 |
Where Pennsylvania sits
The same service costs 5.8 times more in Alaska than in Arkansas. 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· 37th of 51
$2,884
AK $10,000AR $1,738
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.