How much rates vary
Facilitymedian $676 · 10th to 90th $200 to $6,166Professionalmedian $141 · 10th to 90th $132 to $200
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 $151.36 Median $4,897.79 Typical High $8,511.38 | Facility | None | $151.36 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $151.36 | Professional | None | $131.83 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $66.07 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $26.30 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $109.65 Typical High $112.20 | Professional | 54 · Surgery only | $100.00 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $13.18 | $14.79 | $15.14 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $2,290.87 | Facility | None | $380.19 | $660.69 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $281.84 | Professional | None | $134.90 | $134.90 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $281.84 | Professional | None | $151.36 | $204.17 | $281.84 |
Geisinger Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $251.19 | Professional | None | $128.82 | $147.91 | $251.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | None | $158.49 | $158.49 | $186.21 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $3,801.89 Typical High $8,709.64 | Facility | None | $537.03 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $151.36 | Professional | None | $131.83 | $147.91 | $151.36 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $66.07 | $72.44 | $74.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $26.30 | $29.51 | $30.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $109.65 Typical High $112.20 | Professional | 54 · Surgery only | $100.00 | $109.65 | $112.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $22.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $13.18 | $14.79 | $15.14 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $281.84 | Professional | None | $194.98 | $204.17 | $281.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $138.04 Median $501.19 Typical High $741.31 | Facility | None | $138.04 | $501.19 | $741.31 |
UPMC Health Plan Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | None | $138.04 | $138.04 | $141.25 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $223.87 | Professional | None | $125.89 | $147.91 | $223.87 |
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 $134.90 Median $134.90 Typical High $134.90 | Professional | 62 · Two surgeons | $134.90 | $134.90 | $134.90 |
Where Pennsylvania sits
The same service costs 36.6 times more in Maine 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
ME $16,031MT $438
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.