How much rates vary
Facilitymedian $1,660 · 10th to 90th $288 to $7,943Professionalmedian $1,288 · 10th to 90th $245 to $2,344
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 $8,511.38 | Facility | None | $537.03 | $2,344.23 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $1,000.00 Typical High $1,584.89 | Professional | None | $239.88 | $1,000.00 | $1,584.89 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,230.27 | $1,995.26 | $2,951.21 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $3,019.95 Typical High $4,466.84 | Professional | 50 · Both sides | $1,862.09 | $3,019.95 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $630.96 Typical High $1,905.46 | Professional | None | $239.88 | $630.96 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,570.40 | $2,691.53 |
Geisinger Setting Professional Modifier None Typical Low $263.03 Median $1,412.54 Typical High $2,754.23 | Professional | None | $263.03 | $1,412.54 | $2,754.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Highmark BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $331.13 | Professional | None | $263.03 | $263.03 | $331.13 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $8,511.38 | Facility | None | $588.84 | $2,344.23 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $239.88 Median $1,096.48 Typical High $1,584.89 | Professional | None | $239.88 | $1,096.48 | $1,584.89 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $1,412.54 Typical High $2,951.21 | Professional | None | $436.52 | $1,412.54 | $2,951.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $204.17 Median $239.88 Typical High $1,202.26 | Facility | None | $204.17 | $239.88 | $1,202.26 |
UPMC Health Plan Setting Professional Modifier None Typical Low $204.17 Median $1,047.13 Typical High $1,202.26 | Professional | None | $204.17 | $1,047.13 | $1,202.26 |
United Setting Facility Modifier None Typical Low $169.82 Median $524.81 Typical High $3,890.45 | Facility | None | $169.82 | $524.81 | $3,890.45 |
United Setting Professional Modifier None Typical Low $229.09 Median $1,122.02 Typical High $2,089.30 | Professional | None | $229.09 | $1,122.02 | $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 $128.82 Median $194.98 Typical High $794.33 | Professional | 52 · Reduced service | $128.82 | $194.98 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $77.62 Typical High $316.23 | Professional | 53 · Discontinued | $51.29 | $77.62 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $288.40 Typical High $1,174.90 | Professional | 54 · Surgery only | $194.98 | $288.40 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $57.54 Typical High $234.42 | Professional | 55 · Aftercare only | $38.90 | $57.54 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $25.70 | $38.90 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $194.98 Typical High $794.33 | Professional | 52 · Reduced service | $128.82 | $194.98 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $77.62 Typical High $316.23 | Professional | 53 · Discontinued | $51.29 | $77.62 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $288.40 Typical High $1,174.90 | Professional | 54 · Surgery only | $194.98 | $288.40 | $1,174.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $57.54 Typical High $234.42 | Professional | 55 · Aftercare only | $38.90 | $57.54 | $234.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $25.70 | $38.90 | $158.49 |
Where Pennsylvania sits
The same service costs 6.5 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· 17th of 51
$1,288
WA $2,138MD $331
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.