How much rates vary
Facilitymedian $550 · 10th to 90th $295 to $3,020Professionalmedian $117 · 10th to 90th $100 to $224
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 $95.50 Median $114.82 Typical High $117.49 | Professional | None | $95.50 | $114.82 | $117.49 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $56,234.13 | Facility | None | $2,630.27 | $3,019.95 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $229.09 | Professional | None | $114.82 | $181.97 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $467.74 Typical High $794.33 | Facility | None | $354.81 | $467.74 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $234.42 | Professional | None | $100.00 | $123.03 | $234.42 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | None | $177.83 | $177.83 | $204.17 |
Geisinger Setting Facility Modifier None Typical Low $380.19 Median $467.74 Typical High $831.76 | Facility | None | $380.19 | $467.74 | $831.76 |
Geisinger Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $234.42 | Professional | None | $100.00 | $138.04 | $234.42 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $7,244.36 | Facility | None | $588.84 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $114.82 | Professional | None | $95.50 | $114.82 | $114.82 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $218.78 | Professional | None | $131.83 | $154.88 | $218.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $109.65 Median $467.74 Typical High $933.25 | Facility | None | $109.65 | $467.74 | $933.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $123.03 | Professional | None | $109.65 | $117.49 | $123.03 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $2,089.30 | Facility | None | $199.53 | $436.52 | $2,089.30 |
United Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $229.09 | Professional | None | $114.82 | $144.54 | $229.09 |
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 $47.86 Median $54.95 Typical High $57.54 | Professional | 52 · Reduced service | $47.86 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.88 Typical High $22.91 | Professional | 53 · Discontinued | $19.50 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $83.18 Typical High $87.10 | Professional | 54 · Surgery only | $72.44 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $17.38 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.96 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.55 | $10.96 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $53.70 Typical High $57.54 | Professional | 52 · Reduced service | $47.86 | $53.70 | $57.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.88 Typical High $22.91 | Professional | 53 · Discontinued | $19.50 | $21.88 | $22.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $81.28 Typical High $87.10 | Professional | 54 · Surgery only | $72.44 | $81.28 | $87.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.22 Typical High $17.38 | Professional | 55 · Aftercare only | $14.45 | $16.22 | $17.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.72 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.55 | $10.72 | $11.48 |
Where Pennsylvania sits
The same service costs 4.4 times more in Alaska 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· 41st of 51
$151
AK $513NY $117
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.