How much rates vary
Facilitymedian $676 · 10th to 90th $251 to $6,166Professionalmedian $282 · 10th to 90th $229 to $468
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 $281.84 Median $4,897.79 Typical High $8,511.38 | Facility | None | $281.84 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | None | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.12 | $28.18 | $28.18 |
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 $363.08 Median $363.08 Typical High $56,234.13 | Professional | None | $363.08 | $363.08 | $56,234.13 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $2,089.30 | Facility | None | $446.68 | $645.65 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $467.74 | Professional | None | $223.87 | $269.15 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | None | $331.13 | $331.13 | $371.54 |
Geisinger Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $537.03 | Professional | None | $245.47 | $316.23 | $537.03 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $3,801.89 Typical High $8,709.64 | Facility | None | $537.03 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | None | $251.19 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $125.89 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $50.12 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $190.55 | $208.93 | $208.93 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.12 | $28.18 | $28.18 |
Oscar Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $512.86 | Professional | None | $302.00 | $302.00 | $512.86 |
UPMC Health Plan Setting Facility Modifier None Typical Low $229.09 Median $269.15 Typical High $269.15 | Facility | None | $229.09 | $269.15 | $269.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $269.15 | Professional | None | $229.09 | $234.42 | $269.15 |
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 $218.78 Median $309.03 Typical High $489.78 | Professional | None | $218.78 | $309.03 | $489.78 |
1 more rate 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 |
|---|---|---|---|---|---|
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 62 · Two surgeons | $251.19 | $251.19 | $251.19 |
Where Pennsylvania sits
The same service costs 37.1 times more in Alabama 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
AL $26,028MT $702
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.