How much rates vary
Facilitymedian $1,862 · 10th to 90th $617 to $6,026Professionalmedian $372 · 10th to 90th $302 to $661
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 $676.08 Median $3,801.89 Typical High $8,317.64 | Facility | None | $676.08 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $380.19 | Professional | None | $302.00 | $363.08 | $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 $338.84 Median $537.03 Typical High $691.83 | Professional | None | $338.84 | $537.03 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $2,754.23 | Facility | None | $524.81 | $1,659.59 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $660.69 | Professional | None | $331.13 | $380.19 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | None | $478.63 | $478.63 | $512.86 |
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 $309.03 Median $416.87 Typical High $691.83 | Professional | None | $309.03 | $416.87 | $691.83 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $8,317.64 | Facility | None | $758.58 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $371.54 | Professional | None | $302.00 | $363.08 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $794.33 | Professional | None | $380.19 | $457.09 | $794.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $331.13 Median $3,090.30 Typical High $5,370.32 | Facility | None | $331.13 | $3,090.30 | $5,370.32 |
UPMC Health Plan Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $436.52 | Professional | None | $331.13 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,897.79 | Facility | None | $812.83 | $1,318.26 | $4,897.79 |
United Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $691.83 | Professional | None | $323.59 | $407.38 | $691.83 |
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 $151.36 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $45.71 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.20 | $36.31 | $36.31 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $812.83 Typical High $1,023.29 | Professional | 50 · Both sides | $512.86 | $812.83 | $1,023.29 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $151.36 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $60.26 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $45.71 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.20 | $36.31 | $36.31 |
Where Pennsylvania sits
The same service costs 4.7 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· 42nd of 51
$457
AK $1,622NY $347
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.