How much rates vary
Facilitymedian $2,042 · 10th to 90th $457 to $5,495Professionalmedian $135 · 10th to 90th $112 to $229
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 $501.19 Median $1,995.26 Typical High $7,943.28 | Facility | None | $501.19 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | None | $123.03 | $134.90 | $158.49 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | None | $117.49 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,659.59 Typical High $3,311.31 | Facility | None | $338.84 | $1,659.59 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $269.15 | Professional | None | $112.20 | $131.83 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | None | $158.49 | $158.49 | $165.96 |
Geisinger Setting Facility Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $4,365.16 | Facility | None | $1,995.26 | $2,511.89 | $4,365.16 |
Geisinger Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $269.15 | Professional | None | $114.82 | $151.36 | $269.15 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $1,995.26 Typical High $7,244.36 | Facility | None | $537.03 | $1,995.26 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $151.36 | Professional | None | $123.03 | $134.90 | $151.36 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $251.19 | Professional | None | $154.88 | $154.88 | $251.19 |
UPMC Health Plan Setting Facility Modifier None Typical Low $112.20 Median $1,122.02 Typical High $2,238.72 | Facility | None | $112.20 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $177.83 | Professional | None | $112.20 | $117.49 | $177.83 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,623.41 | Facility | None | $1,148.15 | $1,905.46 | $5,623.41 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $239.88 | Professional | None | $104.71 | $144.54 | $239.88 |
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 $61.66 Median $67.61 Typical High $69.18 | Professional | 52 · Reduced service | $61.66 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $27.54 | Professional | 53 · Discontinued | $24.55 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $13.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $67.61 Typical High $69.18 | Professional | 52 · Reduced service | $61.66 | $67.61 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $27.54 | Professional | 53 · Discontinued | $24.55 | $26.92 | $27.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $93.33 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $20.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $13.80 |
Where Pennsylvania sits
The same service costs 12.9 times more in Arkansas than in New York. 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
$191
AR $1,585NY $123
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.