How much rates vary
Facilitymedian $3,631 · 10th to 90th $537 to $14,791Professionalmedian $1,905 · 10th to 90th $363 to $3,388
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 $467.74 Median $2,951.21 Typical High $7,943.28 | Facility | None | $467.74 | $2,951.21 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,202.26 Typical High $2,454.71 | Professional | None | $371.54 | $1,202.26 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $263.03 | Professional | None | $239.88 | $251.19 | $263.03 |
AmeriHealth Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $36,307.81 | Facility | None | $2,511.89 | $3,311.31 | $36,307.81 |
AmeriHealth Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | None | $199.53 | $199.53 | $323.59 |
Capital Blue Cross Setting Facility Modifier None Typical Low $8,709.64 Median $12,022.64 Typical High $56,234.13 | Facility | None | $8,709.64 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,884.03 | $4,168.69 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $4,365.16 Typical High $6,165.95 | Professional | 50 · Both sides | $2,818.38 | $4,365.16 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $912.01 Typical High $2,884.03 | Professional | None | $346.74 | $912.01 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,801.89 Typical High $3,981.07 | Professional | None | $3,162.28 | $3,801.89 | $3,981.07 |
Geisinger Setting Professional Modifier None Typical Low $416.87 Median $2,137.96 Typical High $4,073.80 | Professional | None | $416.87 | $2,137.96 | $4,073.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $12,022.64 Typical High $33,113.11 | Facility | None | $1,230.27 | $12,022.64 | $33,113.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $1,995.26 | Professional | None | $389.05 | $446.68 | $1,995.26 |
Independence Blue Cross Setting Facility Modifier None Typical Low $2,344.23 Median $3,311.31 Typical High $32,359.37 | Facility | None | $2,344.23 | $3,311.31 | $32,359.37 |
Independence Blue Cross Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $338.84 | Professional | None | $199.53 | $199.53 | $338.84 |
Martin's Point Setting Facility Modifier None Typical Low $489.78 Median $3,235.94 Typical High $8,317.64 | Facility | None | $489.78 | $3,235.94 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $371.54 Median $1,122.02 Typical High $2,454.71 | Professional | None | $371.54 | $1,122.02 | $2,454.71 |
Oscar Health Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $4,365.16 | Professional | None | $371.54 | $416.87 | $4,365.16 |
UPMC Health Plan Setting Facility Modifier None Typical Low $316.23 Median $7,943.28 Typical High $14,791.08 | Facility | None | $316.23 | $7,943.28 | $14,791.08 |
UPMC Health Plan Setting Professional Modifier None Typical Low $316.23 Median $1,513.56 Typical High $1,905.46 | Professional | None | $316.23 | $1,513.56 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $6,165.95 Typical High $17,782.79 | Facility | None | $2,454.71 | $6,165.95 | $17,782.79 |
United Setting Professional Modifier None Typical Low $346.74 Median $1,659.59 Typical High $3,090.30 | Professional | None | $346.74 | $1,659.59 | $3,090.30 |
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 $190.55 Median $281.84 Typical High $1,230.27 | Professional | 52 · Reduced service | $190.55 | $281.84 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $114.82 Typical High $489.78 | Professional | 53 · Discontinued | $75.86 | $114.82 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $426.58 Typical High $1,819.70 | Professional | 54 · Surgery only | $288.40 | $426.58 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $85.11 Typical High $363.08 | Professional | 55 · Aftercare only | $57.54 | $85.11 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $57.54 Typical High $245.47 | Professional | 56 · Pre-op care only | $38.02 | $57.54 | $245.47 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $281.84 Typical High $1,230.27 | Professional | 52 · Reduced service | $190.55 | $281.84 | $1,230.27 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $114.82 Typical High $489.78 | Professional | 53 · Discontinued | $75.86 | $114.82 | $489.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $426.58 Typical High $1,819.70 | Professional | 54 · Surgery only | $288.40 | $426.58 | $1,819.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $85.11 Typical High $363.08 | Professional | 55 · Aftercare only | $57.54 | $85.11 | $363.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $57.54 Typical High $245.47 | Professional | 56 · Pre-op care only | $38.02 | $57.54 | $245.47 |
Where Pennsylvania sits
The same service costs 6.2 times more in Washington 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· 21st of 51
$1,905
WA $3,162MD $513
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.