How much rates vary
Facilitymedian $2,089 · 10th to 90th $776 to $6,761Professionalmedian $138 · 10th to 90th $112 to $234
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 $5,370.32 Typical High $8,709.64 | Facility | None | $588.84 | $5,370.32 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $177.83 | Professional | None | $107.15 | $125.89 | $177.83 |
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 $181.97 Median $213.80 Typical High $234.42 | Professional | None | $181.97 | $213.80 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $3,235.94 | Facility | None | $707.95 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $257.04 | Professional | None | $125.89 | $169.82 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | None | $190.55 | $190.55 | $218.78 |
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 $125.89 Median $169.82 Typical High $281.84 | Professional | None | $125.89 | $169.82 | $281.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $7,943.28 Typical High $10,715.19 | Facility | None | $5,623.41 | $7,943.28 | $10,715.19 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $4,897.79 Typical High $8,709.64 | Facility | None | $588.84 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $177.83 | Professional | None | $107.15 | $125.89 | $177.83 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $275.42 | Professional | None | $151.36 | $204.17 | $275.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $123.03 Median $1,778.28 Typical High $3,630.78 | Facility | None | $123.03 | $1,778.28 | $3,630.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $173.78 | Professional | None | $123.03 | $128.82 | $173.78 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,754.40 | Facility | None | $1,148.15 | $1,905.46 | $5,754.40 |
United Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $269.15 | Professional | None | $125.89 | $147.91 | $269.15 |
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 $53.70 Median $63.10 Typical High $66.07 | Professional | 52 · Reduced service | $53.70 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.12 Typical High $26.30 | Professional | 53 · Discontinued | $21.38 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $97.72 | Professional | 54 · Surgery only | $81.28 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.59 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.72 | $12.59 | $13.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $53.70 | $63.10 | $63.10 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $21.38 | $25.12 | $25.12 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | 54 · Surgery only | $81.28 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $18.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.72 | $12.59 | $12.59 |
Where Pennsylvania sits
The same service costs 10.7 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· 42nd of 51
$174
OK $1,413NY $132
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.