How much rates vary
Facilitymedian $2,455 · 10th to 90th $589 to $6,310Professionalmedian $372 · 10th to 90th $275 to $617
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 $3,801.89 Typical High $8,511.38 | Facility | None | $537.03 | $3,801.89 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $426.58 | Professional | None | $251.19 | $275.42 | $426.58 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $794.33 | Professional | None | $524.81 | $776.25 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,137.96 Typical High $3,715.35 | Facility | None | $524.81 | $2,137.96 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $616.60 | Professional | None | $295.12 | $380.19 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $467.74 | Professional | None | $436.52 | $436.52 | $467.74 |
Geisinger Setting Facility Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $4,897.79 | Facility | None | $2,238.72 | $2,754.23 | $4,897.79 |
Geisinger Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $691.83 | Professional | None | $281.84 | $416.87 | $691.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $4,466.84 Typical High $16,982.44 | Facility | None | $3,090.30 | $4,466.84 | $16,982.44 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $3,715.35 Typical High $8,511.38 | Facility | None | $537.03 | $3,715.35 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $426.58 | Professional | None | $251.19 | $275.42 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $794.33 | Professional | None | $354.81 | $489.78 | $794.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $309.03 Median $2,454.71 Typical High $4,265.80 | Facility | None | $309.03 | $2,454.71 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $416.87 | Professional | None | $309.03 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $645.65 | Professional | None | $288.40 | $380.19 | $645.65 |
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 $125.89 Median $138.04 Typical High $147.91 | Professional | 52 · Reduced service | $125.89 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $58.88 | Professional | 53 · Discontinued | $50.12 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $218.78 | Professional | 54 · Surgery only | $190.55 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $29.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $138.04 Typical High $147.91 | Professional | 52 · Reduced service | $125.89 | $138.04 | $147.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $58.88 | Professional | 53 · Discontinued | $50.12 | $54.95 | $58.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $218.78 | Professional | 54 · Surgery only | $190.55 | $208.93 | $218.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $44.67 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $29.51 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 62 · Two surgeons | $398.11 | $398.11 | $398.11 |
Where Pennsylvania sits
The same service costs 10.0 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· 45th of 51
$417
OK $2,884NY $288
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.