How much rates vary
Facilitymedian $603 · 10th to 90th $85 to $4,266Professionalmedian $117 · 10th to 90th $95 to $214
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 $2,454.71 Typical High $8,317.64 | Facility | None | $537.03 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $117.49 | Professional | None | $104.71 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $23.44 | Professional | 53 · Discontinued | $20.89 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $85.11 Typical High $87.10 | Professional | 54 · Surgery only | $79.43 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $17.38 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $17.38 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $218.78 | Professional | None | $95.50 | $169.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $1,174.90 | Facility | None | $446.68 | $602.56 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $208.93 | Professional | None | $93.33 | $120.23 | $208.93 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $169.82 | Professional | None | $95.50 | $128.82 | $169.82 |
Geisinger Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $162.18 | Professional | None | $85.11 | $117.49 | $162.18 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $7,244.36 | Facility | None | $588.84 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $117.49 | Professional | None | $104.71 | $114.82 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $52.48 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $23.44 | Professional | 53 · Discontinued | $20.89 | $22.91 | $23.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $85.11 Typical High $87.10 | Professional | 54 · Surgery only | $79.43 | $85.11 | $87.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $17.38 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $17.38 |
Oscar Health Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $239.88 | Professional | None | $120.23 | $154.88 | $239.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $120.23 | Facility | None | $95.50 | $120.23 | $120.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $95.50 Median $97.72 Typical High $120.23 | Professional | None | $95.50 | $97.72 | $120.23 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,412.54 | Facility | None | $77.62 | $158.49 | $1,412.54 |
United Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $165.96 | Professional | None | $91.20 | $109.65 | $165.96 |
2 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 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $11.75 |
Where Pennsylvania sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 38th of 51
$117
AK $372FL $93.33
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.