How much rates vary
Facilitymedian $1,585 · 10th to 90th $324 to $5,370Professionalmedian $389 · 10th to 90th $324 to $724
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 $537.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $537.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $398.11 | Professional | None | $323.59 | $389.05 | $398.11 |
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 $363.08 Median $588.84 Typical High $741.31 | Professional | None | $363.08 | $588.84 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,659.59 Typical High $3,467.37 | Facility | None | $338.84 | $1,659.59 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $707.95 | Professional | None | $354.81 | $398.11 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | None | $512.86 | $512.86 | $549.54 |
Geisinger Setting Facility Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $4,677.35 | Facility | None | $2,137.96 | $2,630.27 | $4,677.35 |
Geisinger Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $724.44 | Professional | None | $331.13 | $446.68 | $724.44 |
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 $323.59 Median $389.05 Typical High $389.05 | Professional | None | $323.59 | $389.05 | $389.05 |
Oscar Health Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $831.76 | Professional | None | $407.38 | $489.78 | $831.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $354.81 Median $1,122.02 Typical High $2,238.72 | Facility | None | $354.81 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $537.03 | Professional | None | $354.81 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,890.45 | Facility | None | $199.53 | $436.52 | $3,890.45 |
United Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $741.31 | Professional | None | $346.74 | $436.52 | $741.31 |
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 $162.18 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $38.90 | $38.90 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $870.96 Typical High $1,122.02 | Professional | 50 · Both sides | $549.54 | $870.96 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $162.18 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $38.90 | $38.90 |
Where Pennsylvania sits
The same service costs 5.2 times more in Alaska 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
AK $4,868DE $935
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.