How much rates vary
Facilitymedian $589 · 10th to 90th $85 to $5,012Professionalmedian $437 · 10th to 90th $355 to $741
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 $537.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $537.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $645.65 | Professional | None | $389.05 | $436.52 | $645.65 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $56,234.13 | Facility | None | $3,981.07 | $5,011.87 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $776.25 | Professional | None | $363.08 | $630.96 | $776.25 |
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 $354.81 Median $426.58 Typical High $741.31 | Professional | None | $354.81 | $426.58 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | None | $524.81 | $524.81 | $602.56 |
Geisinger Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $741.31 | Professional | None | $389.05 | $501.19 | $741.31 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $2,344.23 Typical High $7,244.36 | Facility | None | $537.03 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $645.65 | Professional | None | $389.05 | $436.52 | $645.65 |
UPMC Health Plan Setting Facility Modifier None Typical Low $354.81 Median $426.58 Typical High $426.58 | Facility | None | $354.81 | $426.58 | $426.58 |
UPMC Health Plan Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $426.58 | Professional | None | $354.81 | $371.54 | $426.58 |
United Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $1,230.27 | Facility | None | $70.79 | $141.25 | $1,230.27 |
United Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $776.25 | Professional | None | $346.74 | $489.78 | $776.25 |
11 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 $194.98 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $295.12 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $58.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $43.65 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $933.25 Typical High $1,148.15 | Professional | 50 · Both sides | $549.54 | $933.25 | $1,148.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $295.12 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $58.88 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $43.65 |
Where Pennsylvania sits
The same service costs 9.7 times more in Alabama than in Delaware. 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
AL $5,872DE $606
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.