How much rates vary
Facilitymedian $1,096 · 10th to 90th $468 to $4,898Professionalmedian $204 · 10th to 90th $186 to $490
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 $186.21 Median $204.17 Typical High $245.47 | Professional | None | $186.21 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $102.33 Typical High $109.65 | Professional | 52 · Reduced service | $93.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $41.69 Typical High $43.65 | Professional | 53 · Discontinued | $37.15 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $154.88 Typical High $162.18 | Professional | 54 · Surgery only | $138.04 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $21.88 |
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 $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $1,737.80 | Facility | None | $478.63 | $891.25 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $489.78 | Professional | None | $190.55 | $245.47 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $380.19 | Professional | None | $199.53 | $281.84 | $380.19 |
Geisinger Setting Facility Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,905.46 | Facility | None | $870.96 | $1,096.48 | $1,905.46 |
Geisinger Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $398.11 | Professional | None | $181.97 | $245.47 | $398.11 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,951.21 | $7,585.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | None | $346.74 | $346.74 | $380.19 |
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 $186.21 Median $204.17 Typical High $229.09 | Professional | None | $186.21 | $204.17 | $229.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $93.33 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $40.74 Typical High $41.69 | Professional | 53 · Discontinued | $37.15 | $40.74 | $41.69 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $138.04 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $20.42 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $537.03 | Professional | None | $316.23 | $316.23 | $537.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $190.55 Median $1,862.09 Typical High $4,365.16 | Facility | None | $190.55 | $1,862.09 | $4,365.16 |
UPMC Health Plan Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $275.42 | Professional | None | $190.55 | $229.09 | $275.42 |
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 $173.78 Median $208.93 Typical High $338.84 | Professional | None | $173.78 | $208.93 | $338.84 |
1 more rate 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 |
|---|---|---|---|---|---|
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 62 · Two surgeons | $245.47 | $245.47 | $245.47 |
Where Pennsylvania sits
The same service costs 6.8 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 $4,179MT $618
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.