How much rates vary
Facilitymedian $3,388 · 10th to 90th $631 to $7,244Professionalmedian $309 · 10th to 90th $263 to $603
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 $676.08 Median $3,801.89 Typical High $8,317.64 | Facility | None | $676.08 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $302.00 | Professional | None | $257.04 | $281.84 | $302.00 |
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 $275.42 Median $446.68 Typical High $616.60 | Professional | None | $275.42 | $446.68 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,370.32 | Facility | None | $501.19 | $2,691.53 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $562.34 | Professional | None | $269.15 | $309.03 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $537.03 | Professional | None | $295.12 | $389.05 | $537.03 |
Geisinger Setting Facility Modifier None Typical Low $3,235.94 Median $4,073.80 Typical High $7,244.36 | Facility | None | $3,235.94 | $4,073.80 | $7,244.36 |
Geisinger Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $549.54 | Professional | None | $263.03 | $338.84 | $549.54 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $8,317.64 | Facility | None | $758.58 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | None | $257.04 | $281.84 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $691.83 | Professional | None | $426.58 | $436.52 | $691.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $269.15 Median $1,737.80 Typical High $3,388.44 | Facility | None | $269.15 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $389.05 | Professional | None | $269.15 | $275.42 | $389.05 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $8,912.51 | Facility | None | $1,698.24 | $3,235.94 | $8,912.51 |
United Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $457.09 | Professional | None | $239.88 | $288.40 | $457.09 |
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 $128.82 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $51.29 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $213.80 | Professional | 54 · Surgery only | $190.55 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $128.82 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $51.29 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $213.80 | Professional | 54 · Surgery only | $190.55 | $208.93 | $213.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $42.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $28.18 |
Where Pennsylvania sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.