How much rates vary
Facilitymedian $1,549 · 10th to 90th $427 to $5,012Professionalmedian $148 · 10th to 90th $87 to $209
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 $158.49 Median $2,454.71 Typical High $8,317.64 | Facility | None | $158.49 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $199.53 | Professional | None | $85.11 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $66.07 Typical High $100.00 | Professional | 52 · Reduced service | $42.66 | $66.07 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $26.30 Typical High $39.81 | Professional | 53 · Discontinued | $16.98 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $100.00 Typical High $147.91 | Professional | 54 · Surgery only | $63.10 | $100.00 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.95 Typical High $29.51 | Professional | 55 · Aftercare only | $12.59 | $19.95 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $13.18 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.51 | $13.18 | $19.95 |
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 $173.78 Median $173.78 Typical High $275.42 | Professional | None | $173.78 | $173.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,380.38 Typical High $2,290.87 | Facility | None | $478.63 | $1,380.38 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $245.47 | Professional | None | $87.10 | $147.91 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $416.87 | Professional | None | $218.78 | $316.23 | $416.87 |
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 $147.91 Median $199.53 Typical High $331.13 | Professional | None | $147.91 | $199.53 | $331.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $4,265.80 Typical High $16,595.87 | Facility | None | $1,148.15 | $4,265.80 | $16,595.87 |
Martin's Point Setting Facility Modifier None Typical Low $104.71 Median $2,187.76 Typical High $7,244.36 | Facility | None | $104.71 | $2,187.76 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $199.53 | Professional | None | $85.11 | $134.90 | $199.53 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $67.61 Typical High $100.00 | Professional | 52 · Reduced service | $42.66 | $67.61 | $100.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $26.92 Typical High $39.81 | Professional | 53 · Discontinued | $16.98 | $26.92 | $39.81 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $102.33 Typical High $147.91 | Professional | 54 · Surgery only | $63.10 | $102.33 | $147.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $20.42 Typical High $29.51 | Professional | 55 · Aftercare only | $12.59 | $20.42 | $29.51 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $13.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.51 | $13.49 | $19.95 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $295.12 | Professional | None | $204.17 | $213.80 | $295.12 |
UPMC Health Plan Setting Facility Modifier None Typical Low $138.04 Median $1,071.52 Typical High $2,511.89 | Facility | None | $138.04 | $1,071.52 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $177.83 | Professional | None | $87.10 | $169.82 | $177.83 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,265.80 | Facility | None | $812.83 | $1,318.26 | $4,265.80 |
United Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $208.93 | Professional | None | $79.43 | $141.25 | $208.93 |
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 59 · Distinct service Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 59 · Distinct service | $151.36 | $151.36 | $151.36 |
Where Pennsylvania sits
The same service costs 3.6 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· 38th of 51
$155
AK $407DC $112
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.