How much rates vary
Facilitymedian $676 · 10th to 90th $240 to $6,310Professionalmedian $617 · 10th to 90th $447 to $1,202
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 $562.34 Median $4,897.79 Typical High $8,511.38 | Facility | None | $562.34 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $630.96 | Professional | None | $501.19 | $562.34 | $630.96 |
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 $446.68 Median $794.33 Typical High $1,348.96 | Professional | None | $446.68 | $794.33 | $1,348.96 |
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 $426.58 Median $724.44 Typical High $1,047.13 | Professional | None | $426.58 | $724.44 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $724.44 | Professional | None | $645.65 | $645.65 | $724.44 |
Geisinger Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,202.26 | Professional | None | $489.78 | $691.83 | $1,202.26 |
Martin's Point Setting Facility Modifier None Typical Low $562.34 Median $3,801.89 Typical High $8,709.64 | Facility | None | $562.34 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $588.84 | Professional | None | $501.19 | $562.34 | $588.84 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | None | $676.08 | $676.08 | $691.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $436.52 Median $588.84 Typical High $588.84 | Facility | None | $436.52 | $588.84 | $588.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $588.84 | Professional | None | $436.52 | $457.09 | $588.84 |
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 $575.44 Median $794.33 Typical High $1,288.25 | Professional | None | $575.44 | $794.33 | $1,288.25 |
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 $251.19 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $380.19 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $56.23 |
Where Pennsylvania sits
The same service costs 13.6 times more in Colorado than in Maryland. 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 $15,162MD $1,112
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.