How much rates vary
Facilitymedian $417 · 10th to 90th $98 to $3,802Professionalmedian $537 · 10th to 90th $447 to $955
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 $2,454.71 Typical High $8,317.64 | Facility | None | $537.03 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $537.03 | Professional | None | $426.58 | $489.78 | $537.03 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,000.00 | Professional | None | $512.86 | $794.33 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $363.08 Typical High $616.60 | Facility | None | $239.88 | $363.08 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $954.99 | Professional | None | $489.78 | $537.03 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | None | $724.44 | $724.44 | $831.76 |
Geisinger Setting Facility Modifier None Typical Low $218.78 Median $275.42 Typical High $478.63 | Facility | None | $218.78 | $275.42 | $478.63 |
Geisinger Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,000.00 | Professional | None | $446.68 | $602.56 | $1,000.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $8,317.64 | Facility | None | $588.84 | $2,344.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $537.03 | Professional | None | $426.58 | $489.78 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,995.26 | Professional | None | $575.44 | $933.25 | $1,995.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $512.86 | Facility | None | $478.63 | $478.63 | $512.86 |
UPMC Health Plan Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | None | $478.63 | $478.63 | $512.86 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $1,071.52 | Professional | None | $467.74 | $537.03 | $1,071.52 |
10 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 $213.80 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $48.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $74.13 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $48.98 |
Where Pennsylvania sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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
$513
AK $1,479AR $427
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.