How much rates vary
Facilitymedian $1,380 · 10th to 90th $380 to $4,266Professionalmedian $195 · 10th to 90th $78 to $355
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 $229.09 Median $2,137.96 Typical High $8,317.64 | Facility | None | $229.09 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $165.96 Typical High $229.09 | Professional | None | $77.62 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $72.44 Typical High $114.82 | Professional | 52 · Reduced service | $38.90 | $72.44 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $28.84 Typical High $45.71 | Professional | 53 · Discontinued | $15.85 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $107.15 Typical High $169.82 | Professional | 54 · Surgery only | $58.88 | $107.15 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $21.38 Typical High $33.88 | Professional | 55 · Aftercare only | $11.75 | $21.38 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $14.45 Typical High $22.91 | Professional | 56 · Pre-op care only | $7.76 | $14.45 | $22.91 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $8,709.64 | Facility | None | $3,981.07 | $4,365.16 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $398.11 | Professional | None | $194.98 | $288.40 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,348.96 Typical High $2,290.87 | Facility | None | $338.84 | $1,348.96 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $154.88 Typical High $263.03 | Professional | None | $70.79 | $154.88 | $263.03 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $501.19 | Professional | None | $275.42 | $371.54 | $501.19 |
Geisinger Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $3,019.95 | Facility | None | $1,380.38 | $1,737.80 | $3,019.95 |
Geisinger Setting Professional Modifier None Typical Low $56.23 Median $199.53 Typical High $354.81 | Professional | None | $56.23 | $199.53 | $354.81 |
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 $77.62 Median $186.21 Typical High $229.09 | Professional | None | $77.62 | $186.21 | $229.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $74.13 Typical High $114.82 | Professional | 52 · Reduced service | $38.90 | $74.13 | $114.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $29.51 Typical High $45.71 | Professional | 53 · Discontinued | $15.85 | $29.51 | $45.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $109.65 Typical High $169.82 | Professional | 54 · Surgery only | $58.88 | $109.65 | $169.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $22.39 Typical High $33.88 | Professional | 55 · Aftercare only | $11.75 | $22.39 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $14.79 Typical High $22.91 | Professional | 56 · Pre-op care only | $7.76 | $14.79 | $22.91 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $407.38 | Professional | None | $107.15 | $112.20 | $407.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $77.62 Median $812.83 Typical High $1,862.09 | Facility | None | $77.62 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $199.53 | Professional | None | $77.62 | $144.54 | $199.53 |
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 $75.86 Median $151.36 Typical High $234.42 | Professional | None | $75.86 | $151.36 | $234.42 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 33 · Preventive service | $83.18 | $83.18 | $83.18 |
Where Pennsylvania sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 22nd of 51
$195
AK $437DC $97.72
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.