How much rates vary
Facilitymedian $1,318 · 10th to 90th $447 to $4,677Professionalmedian $41 · 10th to 90th $34 to $68
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 $33.88 Median $40.74 Typical High $41.69 | Professional | None | $33.88 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $16.98 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $30.90 Typical High $30.90 | Professional | 54 · Surgery only | $25.70 | $30.90 | $30.90 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,981.07 | $6,025.60 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $67.61 | Professional | None | $37.15 | $53.70 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $933.25 Typical High $1,659.59 | Facility | None | $338.84 | $933.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $79.43 | Professional | None | $36.31 | $40.74 | $79.43 |
Emblem Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $54.95 | Professional | None | $51.29 | $51.29 | $54.95 |
Geisinger Setting Facility Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,137.96 | Facility | None | $977.24 | $1,202.26 | $2,137.96 |
Geisinger Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $75.86 | Professional | None | $33.88 | $46.77 | $75.86 |
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 $33.88 Median $40.74 Typical High $41.69 | Professional | None | $33.88 | $40.74 | $41.69 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $16.98 | $20.42 | $20.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $30.90 Typical High $30.90 | Professional | 54 · Surgery only | $25.70 | $30.90 | $30.90 |
Oscar Health Setting Professional Modifier None Typical Low $3.02 Median $47.86 Typical High $83.18 | Professional | None | $3.02 | $47.86 | $83.18 |
UPMC Health Plan Setting Facility Modifier None Typical Low $37.15 Median $1,122.02 Typical High $2,187.76 | Facility | None | $37.15 | $1,122.02 | $2,187.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $38.90 | Professional | None | $37.15 | $38.90 | $38.90 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $3,981.07 | Facility | None | $812.83 | $1,318.26 | $3,981.07 |
United Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $77.62 | Professional | None | $35.48 | $44.67 | $77.62 |
7 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 53 · Discontinued Typical Low $6.76 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $6.76 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.13 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.39 | $4.07 | $4.07 |
Highmark BCBS Setting Facility Modifier XP · Separate practitioner Typical Low $0.50 Median $0.50 Typical High $0.50 | Facility | XP · Separate practitioner | $0.50 | $0.50 | $0.50 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $6.76 | $8.13 | $8.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.13 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.39 | $4.07 | $4.07 |
Where Pennsylvania sits
The same service costs 38.8 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 $4,523MT $116
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.