How much rates vary
Facilitymedian $1,380 · 10th to 90th $490 to $5,248Professionalmedian $1,349 · 10th to 90th $158 to $2,512
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 $645.65 Median $3,090.30 Typical High $8,511.38 | Facility | None | $645.65 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $1,023.29 Typical High $1,905.46 | Professional | None | $162.18 | $1,023.29 | $1,905.46 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $3,162.28 | Professional | None | $1,230.27 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,148.15 Typical High $2,187.76 | Facility | None | $501.19 | $1,148.15 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $346.74 Typical High $2,454.71 | Professional | None | $144.54 | $346.74 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,290.87 | Professional | None | $2,238.72 | $2,238.72 | $2,290.87 |
Geisinger Setting Facility Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,398.83 | Facility | None | $1,096.48 | $1,380.38 | $2,398.83 |
Geisinger Setting Professional Modifier None Typical Low $204.17 Median $1,737.80 Typical High $2,754.23 | Professional | None | $204.17 | $1,737.80 | $2,754.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,466.84 | Facility | None | $4,073.80 | $4,073.80 | $4,466.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,445.44 | $2,137.96 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $8,317.64 | Facility | None | $724.44 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $162.18 Median $1,258.93 Typical High $1,862.09 | Professional | None | $162.18 | $1,258.93 | $1,862.09 |
Oscar Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,905.46 | $1,905.46 | $1,995.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $147.91 Median $2,089.30 Typical High $3,890.45 | Facility | None | $147.91 | $2,089.30 | $3,890.45 |
UPMC Health Plan Setting Professional Modifier None Typical Low $147.91 Median $1,318.26 Typical High $1,737.80 | Professional | None | $147.91 | $1,318.26 | $1,737.80 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,890.45 | Facility | None | $416.87 | $724.44 | $3,890.45 |
United Setting Professional Modifier None Typical Low $154.88 Median $1,230.27 Typical High $2,754.23 | Professional | None | $154.88 | $1,230.27 | $2,754.23 |
11 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 $81.28 Median $109.65 Typical High $933.25 | Professional | 52 · Reduced service | $81.28 | $109.65 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $44.67 Typical High $371.54 | Professional | 53 · Discontinued | $33.11 | $44.67 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $165.96 Typical High $1,380.38 | Professional | 54 · Surgery only | $123.03 | $165.96 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.11 Typical High $275.42 | Professional | 55 · Aftercare only | $24.55 | $33.11 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $186.21 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $186.21 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $3,630.78 Typical High $4,786.30 | Professional | 50 · Both sides | $1,862.09 | $3,630.78 | $4,786.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $109.65 Typical High $933.25 | Professional | 52 · Reduced service | $81.28 | $109.65 | $933.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $44.67 Typical High $371.54 | Professional | 53 · Discontinued | $33.11 | $44.67 | $371.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $165.96 Typical High $1,380.38 | Professional | 54 · Surgery only | $123.03 | $165.96 | $1,380.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.11 Typical High $275.42 | Professional | 55 · Aftercare only | $24.55 | $33.11 | $275.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $186.21 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $186.21 |
Where Pennsylvania sits
The same service costs 8.5 times more in Wisconsin than in Nebraska. 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· 28th of 51
$1,349
WI $2,291NE $269
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.