How much rates vary
Facilitymedian $724 · 10th to 90th $302 to $8,710Professionalmedian $589 · 10th to 90th $479 to $1,000
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 $588.84 Median $6,606.93 Typical High $14,454.40 | Facility | None | $588.84 | $6,606.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | None | $524.81 | $588.84 | $588.84 |
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 $478.63 Median $831.76 Typical High $1,047.13 | Professional | None | $478.63 | $831.76 | $1,047.13 |
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 $467.74 Median $588.84 Typical High $1,023.29 | Professional | None | $467.74 | $588.84 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | None | $707.95 | $707.95 | $794.33 |
Geisinger Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,000.00 | Professional | None | $524.81 | $660.69 | $1,000.00 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $5,754.40 Typical High $14,791.08 | Facility | None | $588.84 | $5,754.40 | $14,791.08 |
Martin's Point Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | None | $524.81 | $588.84 | $588.84 |
Oscar Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
UPMC Health Plan Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $575.44 | Facility | None | $478.63 | $575.44 | $575.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $575.44 | Professional | None | $478.63 | $489.78 | $575.44 |
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 $457.09 Median $660.69 Typical High $1,047.13 | Professional | None | $457.09 | $660.69 | $1,047.13 |
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 $263.03 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $288.40 | $288.40 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $58.88 | $58.88 |
Where Pennsylvania sits
The same service costs 3.8 times more in Wisconsin 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· 44th of 51
$589
WI $1,950NY $513
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.