How much rates vary
Facilitymedian $1,862 · 10th to 90th $398 to $6,607Professionalmedian $355 · 10th to 90th $195 to $631
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 $239.88 Median $933.25 Typical High $6,760.83 | Facility | None | $239.88 | $933.25 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $478.63 | Professional | None | $194.98 | $354.81 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $91.20 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $36.31 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $138.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $27.54 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $18.20 | $33.88 | $39.81 |
AmeriHealth Setting Facility Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $21,379.62 | Facility | None | $2,951.21 | $3,715.35 | $21,379.62 |
AmeriHealth Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
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 $616.60 Median $691.83 Typical High $758.58 | Professional | None | $616.60 | $691.83 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $2,818.38 | Facility | None | $524.81 | $1,659.59 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $707.95 | Professional | None | $213.80 | $354.81 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | None | $645.65 | $645.65 | $691.83 |
Geisinger Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,715.35 | Facility | None | $1,698.24 | $2,089.30 | $3,715.35 |
Geisinger Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $691.83 | Professional | None | $302.00 | $426.58 | $691.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $7,244.36 Typical High $14,454.40 | Facility | None | $2,884.03 | $7,244.36 | $14,454.40 |
Independence Blue Cross Setting Facility Modifier None Typical Low $2,691.53 Median $3,801.89 Typical High $12,882.50 | Facility | None | $2,691.53 | $3,801.89 | $12,882.50 |
Independence Blue Cross Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
Martin's Point Setting Facility Modifier None Typical Low $295.12 Median $1,096.48 Typical High $6,760.83 | Facility | None | $295.12 | $1,096.48 | $6,760.83 |
Martin's Point Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $478.63 | Professional | None | $194.98 | $354.81 | $478.63 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $151.36 Typical High $199.53 | Professional | 52 · Reduced service | $89.13 | $151.36 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $60.26 Typical High $79.43 | Professional | 53 · Discontinued | $35.48 | $60.26 | $79.43 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $223.87 Typical High $302.00 | Professional | 54 · Surgery only | $131.83 | $223.87 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $44.67 Typical High $60.26 | Professional | 55 · Aftercare only | $26.92 | $44.67 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $17.78 | $30.20 | $39.81 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $758.58 | Professional | None | $346.74 | $398.11 | $758.58 |
UPMC Health Plan Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $891.25 | Facility | None | $288.40 | $426.58 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $426.58 | Professional | None | $218.78 | $338.84 | $426.58 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,466.84 | Facility | None | $812.83 | $1,318.26 | $4,466.84 |
United Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $660.69 | Professional | None | $223.87 | $380.19 | $660.69 |
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 |
|---|---|---|---|---|---|
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 62 · Two surgeons | $288.40 | $288.40 | $288.40 |
Where Pennsylvania sits
The same service costs 5.9 times more in Oklahoma than in West Virginia. 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
OK $4,893WV $835
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.