How much rates vary
Facilitymedian $407 · 10th to 90th $95 to $3,890Professionalmedian $117 · 10th to 90th $98 to $195
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 $112.20 Median $125.89 Typical High $125.89 | Professional | None | $112.20 | $125.89 | $125.89 |
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 $107.15 Median $165.96 Typical High $213.80 | Professional | None | $107.15 | $165.96 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $851.14 | Facility | None | $263.03 | $489.78 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $208.93 | Professional | None | $89.13 | $102.33 | $208.93 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $186.21 | Professional | None | $102.33 | $138.04 | $186.21 |
Geisinger Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $524.81 | Facility | None | $239.88 | $295.12 | $524.81 |
Geisinger Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $190.55 | Professional | None | $91.20 | $104.71 | $190.55 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $8,317.64 | Facility | None | $724.44 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | None | $112.20 | $125.89 | $125.89 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $208.93 | Professional | None | $177.83 | $194.98 | $208.93 |
UPMC Health Plan Setting Facility Modifier None Typical Low $81.28 Median $229.09 Typical High $467.74 | Facility | None | $81.28 | $229.09 | $467.74 |
UPMC Health Plan Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $102.33 | Professional | None | $81.28 | $97.72 | $102.33 |
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 $95.50 Median $112.20 Typical High $169.82 | Professional | None | $95.50 | $112.20 | $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 $56.23 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $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 $11.22 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $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 $11.22 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $12.59 |
Where Pennsylvania sits
The same service costs 4.8 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· 34th of 51
$123
AK $427FL $89.13
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.