How much rates vary
Facilitymedian $525 · 10th to 90th $302 to $3,311Professionalmedian $562 · 10th to 90th $468 to $1,023
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 $562.34 Median $2,344.23 Typical High $8,317.64 | Facility | None | $562.34 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $575.44 | Professional | None | $467.74 | $562.34 | $575.44 |
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 $524.81 Median $831.76 Typical High $1,071.52 | Professional | None | $524.81 | $831.76 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $436.52 Typical High $645.65 | Facility | None | $309.03 | $436.52 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,000.00 | Professional | None | $512.86 | $562.34 | $1,000.00 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | None | $724.44 | $724.44 | $776.25 |
Geisinger Setting Facility Modifier None Typical Low $302.00 Median $380.19 Typical High $660.69 | Facility | None | $302.00 | $380.19 | $660.69 |
Geisinger Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,023.29 | Professional | None | $478.63 | $645.65 | $1,023.29 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $7,244.36 | Facility | None | $588.84 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $562.34 | Professional | None | $467.74 | $562.34 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,202.26 | Professional | None | $588.84 | $707.95 | $1,202.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $512.86 Median $1,122.02 Typical High $2,238.72 | Facility | None | $512.86 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $776.25 | Professional | None | $512.86 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $2,089.30 | Facility | None | $199.53 | $436.52 | $2,089.30 |
United Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,071.52 | Professional | None | $501.19 | $616.60 | $1,071.52 |
11 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 $234.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $56.23 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,258.93 Typical High $1,584.89 | Professional | 50 · Both sides | $794.33 | $1,258.93 | $1,584.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $56.23 |
Where Pennsylvania sits
The same service costs 4.0 times more in Alaska than in Utah. 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· 44th of 51
$562
AK $2,089UT $525
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.