How much rates vary
Facilitymedian $2,692 · 10th to 90th $339 to $7,586Professionalmedian $794 · 10th to 90th $263 to $1,479
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 $323.59 Median $1,445.44 Typical High $8,317.64 | Facility | None | $323.59 | $1,445.44 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $758.58 Typical High $1,230.27 | Professional | None | $269.15 | $758.58 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $263.03 | Professional | None | $109.65 | $218.78 | $263.03 |
AmeriHealth Setting Facility Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $18,197.01 | Facility | None | $2,951.21 | $3,715.35 | $18,197.01 |
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 $776.25 Median $1,047.13 Typical High $1,905.46 | Professional | None | $776.25 | $1,047.13 | $1,905.46 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,584.89 Typical High $2,884.03 | Professional | 50 · Both sides | $1,148.15 | $1,584.89 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $602.56 Typical High $1,380.38 | Professional | None | $239.88 | $602.56 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,318.26 | $1,412.54 |
Geisinger Setting Professional Modifier None Typical Low $302.00 Median $1,122.02 Typical High $1,862.09 | Professional | None | $302.00 | $1,122.02 | $1,862.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $5,011.87 Typical High $19,054.61 | Facility | None | $1,905.46 | $5,011.87 | $19,054.61 |
Highmark BCBS Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | None | $275.42 | $316.23 | $338.84 |
Independence Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $17,378.01 | Facility | None | $2,511.89 | $3,715.35 | $17,378.01 |
Martin's Point Setting Facility Modifier None Typical Low $338.84 Median $1,584.89 Typical High $8,317.64 | Facility | None | $338.84 | $1,584.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $269.15 Median $707.95 Typical High $1,174.90 | Professional | None | $269.15 | $707.95 | $1,174.90 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $912.01 Typical High $2,754.23 | Professional | None | $346.74 | $912.01 | $2,754.23 |
UPMC Health Plan Setting Facility Modifier None Typical Low $239.88 Median $2,089.30 Typical High $3,801.89 | Facility | None | $239.88 | $2,089.30 | $3,801.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $794.33 | Professional | None | $239.88 | $316.23 | $794.33 |
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 $245.47 Median $562.34 Typical High $1,548.82 | Professional | None | $245.47 | $562.34 | $1,548.82 |
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 $134.90 Median $208.93 Typical High $524.81 | Professional | 52 · Reduced service | $134.90 | $208.93 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $83.18 Typical High $208.93 | Professional | 53 · Discontinued | $53.70 | $83.18 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $316.23 Typical High $794.33 | Professional | 54 · Surgery only | $199.53 | $316.23 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $63.10 Typical High $158.49 | Professional | 55 · Aftercare only | $39.81 | $63.10 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $41.69 Typical High $104.71 | Professional | 56 · Pre-op care only | $26.92 | $41.69 | $104.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $199.53 Typical High $524.81 | Professional | 52 · Reduced service | $134.90 | $199.53 | $524.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $79.43 Typical High $208.93 | Professional | 53 · Discontinued | $53.70 | $79.43 | $208.93 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $295.12 Typical High $794.33 | Professional | 54 · Surgery only | $199.53 | $295.12 | $794.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $58.88 Typical High $158.49 | Professional | 55 · Aftercare only | $39.81 | $58.88 | $158.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $104.71 | Professional | 56 · Pre-op care only | $26.92 | $39.81 | $104.71 |
Where Pennsylvania sits
The same service costs 4.3 times more in Wisconsin 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· 27th of 51
$794
WI $1,380HI $324
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.