How much rates vary
Facilitymedian $1,585 · 10th to 90th $324 to $4,786Professionalmedian $380 · 10th to 90th $316 to $708
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 $316.23 Median $380.19 Typical High $380.19 | Professional | None | $316.23 | $380.19 | $380.19 |
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 $354.81 Median $562.34 Typical High $724.44 | Professional | None | $354.81 | $562.34 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,584.89 Typical High $2,754.23 | Facility | None | $338.84 | $1,584.89 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $676.08 | Professional | None | $338.84 | $389.05 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | None | $489.78 | $489.78 | $524.81 |
Geisinger Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,089.30 | $3,630.78 |
Geisinger Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $691.83 | Professional | None | $323.59 | $436.52 | $691.83 |
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 $316.23 Median $380.19 Typical High $380.19 | Professional | None | $316.23 | $380.19 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $794.33 | Professional | None | $398.11 | $426.58 | $794.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $346.74 Median $1,122.02 Typical High $2,238.72 | Facility | None | $346.74 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | None | $346.74 | $363.08 | $363.08 |
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 $331.13 Median $416.87 Typical High $724.44 | Professional | None | $331.13 | $416.87 | $724.44 |
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 $158.49 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $31.62 | $38.02 | $38.02 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $851.14 Typical High $1,071.52 | Professional | 50 · Both sides | $537.03 | $851.14 | $1,071.52 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $63.10 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $234.42 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $31.62 | $38.02 | $38.02 |
Where Pennsylvania sits
The same service costs 3.9 times more in Alaska than in New York. 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· 47th of 51
$398
AK $1,413NY $363
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.