How much rates vary
Facilitymedian $2,455 · 10th to 90th $316 to $7,244Professionalmedian $1,175 · 10th to 90th $240 to $2,188
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 $316.23 Median $1,698.24 Typical High $8,317.64 | Facility | None | $316.23 | $1,698.24 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $977.24 Typical High $1,584.89 | Professional | None | $251.19 | $977.24 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $1,096.48 | Professional | None | $114.82 | $208.93 | $1,096.48 |
AmeriHealth Setting Facility Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $47,863.01 | Facility | None | $2,454.71 | $3,162.28 | $47,863.01 |
AmeriHealth Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $309.03 | Professional | None | $154.88 | $239.88 | $309.03 |
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 $1,148.15 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,548.82 | $3,019.95 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,344.23 Typical High $4,466.84 | Professional | 50 · Both sides | $1,698.24 | $2,344.23 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $588.84 Typical High $1,819.70 | Professional | None | $223.87 | $588.84 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,659.59 | $1,995.26 | $2,089.30 |
Geisinger Setting Professional Modifier None Typical Low $275.42 Median $1,348.96 Typical High $2,454.71 | Professional | None | $275.42 | $1,348.96 | $2,454.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,715.35 | Facility | None | $1,862.09 | $2,570.40 | $3,715.35 |
Highmark BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
Independence Blue Cross Setting Facility Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $45,708.82 | Facility | None | $2,137.96 | $3,162.28 | $45,708.82 |
Independence Blue Cross Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $309.03 | Professional | None | $239.88 | $239.88 | $309.03 |
Martin's Point Setting Facility Modifier None Typical Low $316.23 Median $1,819.70 Typical High $8,317.64 | Facility | None | $316.23 | $1,819.70 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $251.19 Median $1,096.48 Typical High $1,584.89 | Professional | None | $251.19 | $1,096.48 | $1,584.89 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $1,380.38 Typical High $2,818.38 | Professional | None | $316.23 | $1,380.38 | $2,818.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $229.09 Median $1,548.82 Typical High $2,884.03 | Facility | None | $229.09 | $1,548.82 | $2,884.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $1,202.26 | Professional | None | $229.09 | $288.40 | $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 $223.87 Median $512.86 Typical High $2,089.30 | Professional | None | $223.87 | $512.86 | $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 $125.89 Median $190.55 Typical High $794.33 | Professional | 52 · Reduced service | $125.89 | $190.55 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $75.86 Typical High $316.23 | Professional | 53 · Discontinued | $50.12 | $75.86 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $288.40 Typical High $1,174.90 | Professional | 54 · Surgery only | $186.21 | $288.40 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $147.91 Typical High $234.42 | Professional | 55 · Aftercare only | $37.15 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $97.72 Typical High $158.49 | Professional | 56 · Pre-op care only | $25.12 | $97.72 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $186.21 Typical High $794.33 | Professional | 52 · Reduced service | $125.89 | $186.21 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $316.23 | Professional | 53 · Discontinued | $50.12 | $74.13 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $281.84 Typical High $1,174.90 | Professional | 54 · Surgery only | $186.21 | $281.84 | $1,174.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $147.91 Typical High $234.42 | Professional | 55 · Aftercare only | $37.15 | $147.91 | $234.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $97.72 Typical High $158.49 | Professional | 56 · Pre-op care only | $25.12 | $97.72 | $158.49 |
Where Pennsylvania sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 19th of 51
$1,175
WA $1,820HI $316
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.