How much rates vary
Facilitymedian $1,995 · 10th to 90th $447 to $6,166Professionalmedian $380 · 10th to 90th $316 to $692
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 $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 $354.81 Median $562.34 Typical High $707.95 | Professional | None | $354.81 | $562.34 | $707.95 |
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 $380.19 Typical High $676.08 | Professional | None | $338.84 | $380.19 | $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 $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 $323.59 Median $426.58 Typical High $691.83 | Professional | None | $323.59 | $426.58 | $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 $446.68 Typical High $794.33 | Professional | None | $398.11 | $446.68 | $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 $416.87 Typical High $416.87 | Professional | None | $346.74 | $416.87 | $416.87 |
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 $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 $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $186.21 | $186.21 |
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 $46.77 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $46.77 | $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 $524.81 Median $851.14 Typical High $1,071.52 | Professional | 50 · Both sides | $524.81 | $851.14 | $1,071.52 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $186.21 | $186.21 |
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 $46.77 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $46.77 | $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 7.8 times more in Oklahoma 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· 46th of 51
$427
OK $2,630NY $339
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.