How much rates vary
Facilitymedian $1,820 · 10th to 90th $759 to $6,761Professionalmedian $631 · 10th to 90th $513 to $1,000
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 $616.60 Median $2,454.71 Typical High $8,511.38 | Facility | None | $616.60 | $2,454.71 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | None | $512.86 | $575.44 | $616.60 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $1,148.15 | Professional | None | $630.96 | $660.69 | $1,148.15 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,000.00 Typical High $1,698.24 | Professional | 50 · Both sides | $954.99 | $1,000.00 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,513.56 Typical High $3,388.44 | Facility | None | $575.44 | $1,513.56 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,230.27 | Professional | None | $537.03 | $630.96 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $524.81 | Professional | None | $363.08 | $467.74 | $524.81 |
Geisinger Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $660.69 | Professional | None | $281.84 | $288.40 | $660.69 |
Martin's Point Setting Facility Modifier None Typical Low $616.60 Median $2,454.71 Typical High $8,317.64 | Facility | None | $616.60 | $2,454.71 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $616.60 | Professional | None | $512.86 | $562.34 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $12.88 Median $645.65 Typical High $1,148.15 | Professional | None | $12.88 | $645.65 | $1,148.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $616.60 Median $933.25 Typical High $933.25 | Facility | None | $616.60 | $933.25 | $933.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $933.25 | Professional | None | $616.60 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $5,495.41 | Facility | None | $1,148.15 | $1,819.70 | $5,495.41 |
United Setting Professional Modifier None Typical Low $338.84 Median $691.83 Typical High $954.99 | Professional | None | $338.84 | $691.83 | $954.99 |
11 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 $257.04 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $61.66 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $275.42 | $309.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $109.65 | $123.03 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $416.87 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $61.66 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 62 · Two surgeons | $891.25 | $891.25 | $891.25 |
Where Pennsylvania sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 27th of 51
$631
AK $2,455KY $245
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.