How much rates vary
Facilitymedian $117 · 10th to 90th $56 to $977Professionalmedian $93 · 10th to 90th $74 to $158
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 $74.13 Median $85.11 Typical High $85.11 | Facility | None | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $85.11 Typical High $114.82 | Professional | None (both parts) | $69.18 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $46.77 Typical High $53.70 | Professional | 26 · Professional part | $38.90 | $46.77 | $53.70 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $38.02 Typical High $63.10 | Professional | TC · Technical part | $30.90 | $38.02 | $63.10 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None (both parts) Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None (both parts) | $144.54 | $144.54 | $144.54 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $45.71 Median $72.44 Typical High $95.50 | Professional | 26 · Professional part | $45.71 | $72.44 | $95.50 |
Capital Blue Cross Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $53.70 Typical High $72.44 | Professional | TC · Technical part | $39.81 | $53.70 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $302.00 Typical High $562.34 | Facility | None | $58.88 | $302.00 | $562.34 |
Cigna Setting Professional Modifier None (both parts) Typical Low $81.28 Median $97.72 Typical High $169.82 | Professional | None (both parts) | $81.28 | $97.72 | $169.82 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $43.65 Median $50.12 Typical High $93.33 | Professional | 26 · Professional part | $43.65 | $50.12 | $93.33 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $52.48 Typical High $79.43 | Professional | TC · Technical part | $38.02 | $52.48 | $79.43 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | None (both parts) | $169.82 | $169.82 | $181.97 |
Geisinger Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $114.82 | Facility | None | $52.48 | $66.07 | $114.82 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $91.20 Median $123.03 Typical High $204.17 | Professional | None (both parts) | $91.20 | $123.03 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $263.03 Median $891.25 Typical High $1,737.80 | Facility | None | $263.03 | $891.25 | $1,737.80 |
Martin's Point Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $69.18 Median $85.11 Typical High $117.49 | Professional | None (both parts) | $69.18 | $85.11 | $117.49 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $46.77 Typical High $53.70 | Professional | 26 · Professional part | $38.90 | $46.77 | $53.70 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $38.02 Typical High $64.57 | Professional | TC · Technical part | $30.90 | $38.02 | $64.57 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $10.00 Median $100.00 Typical High $208.93 | Professional | None (both parts) | $10.00 | $100.00 | $208.93 |
UPMC Health Plan Setting Facility Modifier None Typical Low $81.28 Median $138.04 Typical High $239.88 | Facility | None | $81.28 | $138.04 | $239.88 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | None (both parts) | $81.28 | $95.50 | $95.50 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 26 · Professional part | $42.66 | $42.66 | $44.67 |
UPMC Health Plan Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $52.48 Typical High $52.48 | Professional | TC · Technical part | $36.31 | $52.48 | $52.48 |
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 (both parts) Typical Low $79.43 Median $107.15 Typical High $165.96 | Professional | None (both parts) | $79.43 | $107.15 | $165.96 |
United Setting Professional Modifier 26 · Professional part Typical Low $46.77 Median $61.66 Typical High $93.33 | Professional | 26 · Professional part | $46.77 | $61.66 | $93.33 |
United Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $47.86 Typical High $70.79 | Professional | TC · Technical part | $33.88 | $47.86 | $70.79 |
8 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 $34.67 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $34.67 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $14.13 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $8.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $34.67 | $42.66 | $42.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $14.13 | $16.98 | $16.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $8.51 |
Where Pennsylvania sits
The same service costs 5.9 times more in Alaska than in Alabama. 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· 43rd of 51
$95.50
AK $331AL $56.23
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.