How much rates vary
Facilitymedian $1,862 · 10th to 90th $603 to $5,754Professionalmedian $1,549 · 10th to 90th $372 to $3,236
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 $588.84 Median $3,090.30 Typical High $8,511.38 | Facility | None | $588.84 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $1,047.13 Typical High $2,089.30 | Professional | None | $338.84 | $1,047.13 | $2,089.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $251.19 Typical High $954.99 | Professional | 52 · Reduced service | $169.82 | $251.19 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $100.00 Typical High $389.05 | Professional | 53 · Discontinued | $67.61 | $100.00 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $1,445.44 | Professional | 54 · Surgery only | $251.19 | $380.19 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $75.86 Typical High $288.40 | Professional | 55 · Aftercare only | $50.12 | $75.86 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $50.12 Typical High $190.55 | Professional | 56 · Pre-op care only | $33.88 | $50.12 | $190.55 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,630.27 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $3,311.31 | Facility | None | $501.19 | $1,659.59 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,122.02 Typical High $3,162.28 | Professional | None | $371.54 | $1,122.02 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,888.44 | Professional | None | $5,623.41 | $5,623.41 | $5,888.44 |
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 $426.58 Median $2,691.53 Typical High $5,370.32 | Professional | None | $426.58 | $2,691.53 | $5,370.32 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $12,302.69 | Facility | None | $2,630.27 | $3,311.31 | $12,302.69 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,691.53 Typical High $8,317.64 | Facility | None | $724.44 | $2,691.53 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $338.84 Median $1,047.13 Typical High $2,238.72 | Professional | None | $338.84 | $1,047.13 | $2,238.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $251.19 Typical High $954.99 | Professional | 52 · Reduced service | $169.82 | $251.19 | $954.99 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $100.00 Typical High $389.05 | Professional | 53 · Discontinued | $67.61 | $100.00 | $389.05 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $1,445.44 | Professional | 54 · Surgery only | $251.19 | $380.19 | $1,445.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $75.86 Typical High $288.40 | Professional | 55 · Aftercare only | $50.12 | $75.86 | $288.40 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $50.12 Typical High $190.55 | Professional | 56 · Pre-op care only | $33.88 | $50.12 | $190.55 |
Oscar Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,995.26 | $2,089.30 | $2,951.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $371.54 Median $426.58 Typical High $1,949.84 | Facility | None | $371.54 | $426.58 | $1,949.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $371.54 Median $1,584.89 Typical High $1,949.84 | Professional | None | $371.54 | $1,584.89 | $1,949.84 |
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 $380.19 Median $1,230.27 Typical High $3,162.28 | Professional | None | $380.19 | $1,230.27 | $3,162.28 |
1 more rate 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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,187.76 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,187.76 | $2,884.03 |
Where Pennsylvania sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 36th of 51
$1,585
IA $2,692NE $741
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.