How much rates vary
Facilitymedian $3,388 · 10th to 90th $589 to $8,710Professionalmedian $1,202 · 10th to 90th $295 to $2,399
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 $2,818.38 Typical High $8,511.38 | Facility | None | $588.84 | $2,818.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $891.25 Typical High $1,548.82 | Professional | None | $302.00 | $891.25 | $1,548.82 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 50 · Both sides | $371.54 | $371.54 | $371.54 |
Capital Blue Cross Setting Facility Modifier None Typical Low $6,760.83 Median $7,413.10 Typical High $56,234.13 | Facility | None | $6,760.83 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,905.46 | $2,818.38 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,818.38 Typical High $4,265.80 | Professional | 50 · Both sides | $1,737.80 | $2,818.38 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $724.44 Typical High $1,949.84 | Professional | None | $275.42 | $724.44 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,187.76 | Professional | None | $1,737.80 | $2,089.30 | $2,187.76 |
Geisinger Setting Professional Modifier None Typical Low $346.74 Median $1,445.44 Typical High $2,570.40 | Professional | None | $346.74 | $1,445.44 | $2,570.40 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Professional | None | $295.12 | $295.12 | $331.13 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,630.27 Typical High $8,709.64 | Facility | None | $588.84 | $2,630.27 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $302.00 Median $1,023.29 Typical High $1,548.82 | Professional | None | $302.00 | $1,023.29 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $1,621.81 Typical High $2,398.83 | Professional | None | $489.78 | $1,621.81 | $2,398.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $269.15 Median $4,466.84 Typical High $8,317.64 | Facility | None | $269.15 | $4,466.84 | $8,317.64 |
UPMC Health Plan Setting Professional Modifier None Typical Low $269.15 Median $1,148.15 Typical High $1,258.93 | Professional | None | $269.15 | $1,148.15 | $1,258.93 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $3,890.45 Typical High $10,000.00 | Facility | None | $2,089.30 | $3,890.45 | $10,000.00 |
United Setting Professional Modifier None Typical Low $281.84 Median $1,096.48 Typical High $2,089.30 | Professional | None | $281.84 | $1,096.48 | $2,089.30 |
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 $151.36 Median $223.87 Typical High $758.58 | Professional | 52 · Reduced service | $151.36 | $223.87 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $89.13 Typical High $302.00 | Professional | 53 · Discontinued | $60.26 | $89.13 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $331.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $229.09 | $331.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $67.61 Typical High $229.09 | Professional | 55 · Aftercare only | $45.71 | $67.61 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $44.67 Typical High $151.36 | Professional | 56 · Pre-op care only | $30.20 | $44.67 | $151.36 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $223.87 Typical High $758.58 | Professional | 52 · Reduced service | $151.36 | $223.87 | $758.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $89.13 Typical High $302.00 | Professional | 53 · Discontinued | $60.26 | $89.13 | $302.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $331.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $229.09 | $331.13 | $1,148.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $67.61 Typical High $229.09 | Professional | 55 · Aftercare only | $45.71 | $67.61 | $229.09 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $44.67 Typical High $151.36 | Professional | 56 · Pre-op care only | $30.20 | $44.67 | $151.36 |
Where Pennsylvania sits
The same service costs 5.1 times more in Wisconsin 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.
Pennsylvania· 29th of 51
$1,202
WI $2,042MD $398
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.