How much rates vary
Facilitymedian $891 · 10th to 90th $347 to $8,710Professionalmedian $468 · 10th to 90th $380 to $891
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 $724.44 Median $5,754.40 Typical High $10,232.93 | Facility | None | $724.44 | $5,754.40 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $660.69 | Professional | None | $416.87 | $467.74 | $660.69 |
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 $389.05 Median $616.60 Typical High $1,258.93 | Professional | None | $389.05 | $616.60 | $1,258.93 |
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 $371.54 Median $630.96 Typical High $933.25 | Professional | None | $371.54 | $630.96 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | None | $549.54 | $549.54 | $630.96 |
Geisinger Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $1,318.26 | Professional | None | $416.87 | $602.56 | $1,318.26 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $5,495.41 Typical High $10,232.93 | Facility | None | $1,023.29 | $5,495.41 | $10,232.93 |
Martin's Point Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $660.69 | Professional | None | $416.87 | $467.74 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $1,318.26 | Professional | None | $15.14 | $15.14 | $1,318.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $616.60 | Facility | None | $380.19 | $616.60 | $616.60 |
UPMC Health Plan Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $616.60 | Professional | None | $380.19 | $389.05 | $616.60 |
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 $371.54 Median $588.84 Typical High $870.96 | Professional | None | $371.54 | $588.84 | $870.96 |
12 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 $208.93 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $46.77 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $933.25 Typical High $1,819.70 | Professional | 50 · Both sides | $575.44 | $933.25 | $1,819.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $208.93 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $316.23 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $46.77 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 62 · Two surgeons | $562.34 | $602.56 | $602.56 |
Where Pennsylvania sits
The same service costs 3.7 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· 45th of 51
$589
WI $1,622NY $437
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.