How much rates vary
Facilitymedian $550 · 10th to 90th $302 to $3,467Professionalmedian $363 · 10th to 90th $87 to $661
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 $467.74 Median $2,344.23 Typical High $8,317.64 | Facility | None | $467.74 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $389.05 Typical High $467.74 | Professional | None | $87.10 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $57.54 Typical High $234.42 | Professional | 52 · Reduced service | $42.66 | $57.54 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.91 Typical High $93.33 | Professional | 53 · Discontinued | $17.38 | $22.91 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $87.10 Typical High $354.81 | Professional | 54 · Surgery only | $64.57 | $87.10 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.38 Typical High $70.79 | Professional | 55 · Aftercare only | $12.88 | $17.38 | $70.79 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $56,234.13 | Facility | None | $2,630.27 | $3,019.95 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $776.25 | Professional | None | $354.81 | $524.81 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $537.03 Typical High $954.99 | Facility | None | $371.54 | $537.03 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $199.53 Typical High $616.60 | Professional | None | $77.62 | $199.53 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | None | $602.56 | $602.56 | $630.96 |
Geisinger Setting Facility Modifier None Typical Low $331.13 Median $416.87 Typical High $741.31 | Facility | None | $331.13 | $416.87 | $741.31 |
Geisinger Setting Professional Modifier None Typical Low $112.20 Median $478.63 Typical High $758.58 | Professional | None | $112.20 | $478.63 | $758.58 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $87.10 Median $389.05 Typical High $467.74 | Professional | None | $87.10 | $389.05 | $467.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $57.54 Typical High $234.42 | Professional | 52 · Reduced service | $42.66 | $57.54 | $234.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.91 Typical High $93.33 | Professional | 53 · Discontinued | $17.38 | $22.91 | $93.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $87.10 Typical High $354.81 | Professional | 54 · Surgery only | $64.57 | $87.10 | $354.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.38 Typical High $70.79 | Professional | 55 · Aftercare only | $12.88 | $17.38 | $70.79 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | None | $478.63 | $478.63 | $501.19 |
UPMC Health Plan Setting Facility Modifier None Typical Low $79.43 Median $104.71 Typical High $446.68 | Facility | None | $79.43 | $104.71 | $446.68 |
UPMC Health Plan Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $446.68 | Professional | None | $79.43 | $354.81 | $446.68 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $1,995.26 | Facility | None | $199.53 | $436.52 | $1,995.26 |
United Setting Professional Modifier None Typical Low $89.13 Median $338.84 Typical High $707.95 | Professional | None | $89.13 | $338.84 | $707.95 |
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 $8.71 Median $11.48 Typical High $46.77 | Professional | 56 · Pre-op care only | $8.71 | $11.48 | $46.77 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $46.77 |
Where Pennsylvania sits
The same service costs 7.8 times more in Oklahoma 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· 39th of 51
$407
OK $1,148NE $148
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.