How much rates vary
Facilitymedian $1,202 · 10th to 90th $490 to $4,571Professionalmedian $115 · 10th to 90th $95 to $186
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 $588.84 Median $3,235.94 Typical High $8,511.38 | Facility | None | $588.84 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
AmeriHealth Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,311.31 | Facility | None | $1,621.81 | $1,621.81 | $3,311.31 |
AmeriHealth Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $56,234.13 | Facility | None | $3,981.07 | $4,365.16 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $204.17 | Professional | None | $104.71 | $162.18 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $870.96 Typical High $1,737.80 | Facility | None | $501.19 | $870.96 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $204.17 | Professional | None | $87.10 | $100.00 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $177.83 | Professional | None | $100.00 | $134.90 | $177.83 |
Geisinger Setting Facility Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,819.70 | Facility | None | $831.76 | $1,047.13 | $1,819.70 |
Geisinger Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $186.21 | Professional | None | $89.13 | $100.00 | $186.21 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,365.16 Typical High $9,549.93 | Facility | None | $3,467.37 | $4,365.16 | $9,549.93 |
Independence Blue Cross Setting Facility Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,890.45 | Facility | None | $1,621.81 | $2,041.74 | $3,890.45 |
Independence Blue Cross Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Martin's Point Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $8,317.64 | Facility | None | $645.65 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $186.21 | Professional | None | $100.00 | $100.00 | $186.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $79.43 Median $1,202.26 Typical High $2,754.23 | Facility | None | $79.43 | $1,202.26 | $2,754.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $102.33 | Professional | None | $79.43 | $97.72 | $102.33 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,467.37 | Facility | None | $416.87 | $724.44 | $3,467.37 |
United Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $169.82 | Professional | None | $93.33 | $109.65 | $169.82 |
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 $57.54 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $57.54 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $22.91 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $93.33 Typical High $95.50 | Professional | 54 · Surgery only | $85.11 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.62 Typical High $19.05 | Professional | 55 · Aftercare only | $16.98 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $57.54 | $61.66 | $63.10 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $22.91 | $25.12 | $25.12 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $93.33 Typical High $95.50 | Professional | 54 · Surgery only | $85.11 | $93.33 | $95.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.62 Typical High $19.05 | Professional | 55 · Aftercare only | $16.98 | $18.62 | $19.05 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $12.59 |
Where Pennsylvania sits
The same service costs 14.5 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,506MT $310
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.