How much rates vary
Facilitymedian $1,862 · 10th to 90th $437 to $6,026Professionalmedian $447 · 10th to 90th $339 to $813
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 $457.09 Median $2,137.96 Typical High $7,943.28 | Facility | None | $457.09 | $2,137.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $457.09 | Professional | None | $309.03 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $154.88 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $61.66 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $234.42 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $46.77 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.90 | $38.02 | $45.71 |
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 $426.58 Median $676.08 Typical High $831.76 | Professional | None | $426.58 | $676.08 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,659.59 Typical High $4,365.16 | Facility | None | $338.84 | $1,659.59 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $724.44 | Professional | None | $338.84 | $446.68 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | None | $707.95 | $707.95 | $758.58 |
Geisinger Setting Facility Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $5,754.40 | Facility | None | $2,630.27 | $3,311.31 | $5,754.40 |
Geisinger Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $933.25 | Professional | None | $398.11 | $562.34 | $933.25 |
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 $309.03 Median $380.19 Typical High $457.09 | Professional | None | $309.03 | $380.19 | $457.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $154.88 | $190.55 | $229.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $61.66 | $75.86 | $91.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $234.42 | $281.84 | $346.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $46.77 | $56.23 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.90 | $38.02 | $45.71 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $977.24 Typical High $1,023.29 | Professional | None | $489.78 | $977.24 | $1,023.29 |
UPMC Health Plan Setting Facility Modifier None Typical Low $338.84 Median $1,000.00 Typical High $1,862.09 | Facility | None | $338.84 | $1,000.00 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $1,000.00 | Professional | None | $338.84 | $398.11 | $1,000.00 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $776.25 | Professional | None | $363.08 | $457.09 | $776.25 |
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 $645.65 Median $1,023.29 Typical High $1,258.93 | Professional | 50 · Both sides | $645.65 | $1,023.29 | $1,258.93 |
Where Pennsylvania sits
The same service costs 6.3 times more in Colorado 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
CO $7,350MT $1,166
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.