How much rates vary
Facilitymedian $1,585 · 10th to 90th $398 to $8,128Professionalmedian $427 · 10th to 90th $324 to $776
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 $446.68 Median $2,137.96 Typical High $8,317.64 | Facility | None | $446.68 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $446.68 | Professional | None | $302.00 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $181.97 Typical High $218.78 | Professional | 52 · Reduced service | $151.36 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $60.26 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $275.42 Typical High $331.13 | Professional | 54 · Surgery only | $223.87 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $54.95 Typical High $66.07 | Professional | 55 · Aftercare only | $44.67 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.20 | $36.31 | $44.67 |
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 $416.87 Median $660.69 Typical High $812.83 | Professional | None | $416.87 | $660.69 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,659.59 Typical High $7,943.28 | Facility | None | $338.84 | $1,659.59 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $691.83 | Professional | None | $331.13 | $426.58 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
Geisinger Setting Facility Modifier None Typical Low $4,897.79 Median $6,025.60 Typical High $10,715.19 | Facility | None | $4,897.79 | $6,025.60 | $10,715.19 |
Geisinger Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $851.14 | Professional | None | $371.54 | $537.03 | $851.14 |
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 $302.00 Median $363.08 Typical High $446.68 | Professional | None | $302.00 | $363.08 | $446.68 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $181.97 Typical High $218.78 | Professional | 52 · Reduced service | $151.36 | $181.97 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $60.26 | $72.44 | $89.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $275.42 Typical High $331.13 | Professional | 54 · Surgery only | $223.87 | $275.42 | $331.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $54.95 Typical High $66.07 | Professional | 55 · Aftercare only | $44.67 | $54.95 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.20 | $36.31 | $44.67 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $977.24 Typical High $1,047.13 | Professional | None | $467.74 | $977.24 | $1,047.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $1,862.09 | Facility | None | $389.05 | $954.99 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $954.99 | Professional | None | $331.13 | $389.05 | $954.99 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $5,011.87 | Facility | None | $416.87 | $724.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $758.58 | Professional | None | $346.74 | $446.68 | $758.58 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $977.24 Typical High $1,202.26 | Professional | 50 · Both sides | $616.60 | $977.24 | $1,202.26 |
Where Pennsylvania sits
The same service costs 9.3 times more in Wyoming than in Delaware. 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 $10,585DE $1,135
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.