How much rates vary
Facilitymedian $427 · 10th to 90th $79 to $4,571Professionalmedian $105 · 10th to 90th $49 to $174
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 $57.54 Median $676.08 Typical High $6,025.60 | Facility | None | $57.54 | $676.08 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $117.49 | Professional | None | $43.65 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $21.38 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $19.05 Typical High $23.44 | Professional | 53 · Discontinued | $8.71 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $72.44 Typical High $87.10 | Professional | 54 · Surgery only | $32.36 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $6.46 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $9.55 Typical High $11.75 | Professional | 56 · Pre-op care only | $4.37 | $9.55 | $11.75 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
AmeriHealth Setting Facility Modifier None Typical Low $691.83 Median $5,623.41 Typical High $8,511.38 | Facility | None | $691.83 | $5,623.41 | $8,511.38 |
AmeriHealth Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $125.89 | Professional | None | $56.23 | $60.26 | $125.89 |
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 Typical Low $109.65 Median $112.20 Typical High $239.88 | Professional | None | $109.65 | $112.20 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $251.19 Typical High $549.54 | Facility | None | $97.72 | $251.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $104.71 Typical High $181.97 | Professional | None | $50.12 | $104.71 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | None | $154.88 | $213.80 | $213.80 |
Geisinger Setting Facility Modifier None Typical Low $89.13 Median $109.65 Typical High $194.98 | Facility | None | $89.13 | $109.65 | $194.98 |
Geisinger Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $239.88 | Professional | None | $75.86 | $138.04 | $239.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $1,348.96 | Facility | None | $467.74 | $794.33 | $1,348.96 |
Independence Blue Cross Setting Facility Modifier None Typical Low $436.52 Median $3,890.45 Typical High $8,317.64 | Facility | None | $436.52 | $3,890.45 | $8,317.64 |
Independence Blue Cross Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $131.83 | Professional | None | $58.88 | $60.26 | $131.83 |
Martin's Point Setting Facility Modifier None Typical Low $70.79 Median $831.76 Typical High $5,754.40 | Facility | None | $70.79 | $831.76 | $5,754.40 |
Martin's Point Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $117.49 | Professional | None | $43.65 | $97.72 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $21.38 | $47.86 | $58.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $19.05 Typical High $23.44 | Professional | 53 · Discontinued | $8.71 | $19.05 | $23.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $72.44 Typical High $87.10 | Professional | 54 · Surgery only | $32.36 | $72.44 | $87.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $6.46 | $14.45 | $17.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $9.55 Typical High $11.75 | Professional | 56 · Pre-op care only | $4.37 | $9.55 | $11.75 |
Oscar Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $213.80 | Professional | None | $120.23 | $120.23 | $213.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $79.43 Median $501.19 Typical High $1,148.15 | Facility | None | $79.43 | $501.19 | $1,148.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $48.98 Median $107.15 Typical High $138.04 | Professional | None | $48.98 | $107.15 | $138.04 |
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 $51.29 Median $95.50 Typical High $158.49 | Professional | None | $51.29 | $95.50 | $158.49 |
1 more rate 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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $169.82 Typical High $363.08 | Professional | 50 · Both sides | $162.18 | $169.82 | $363.08 |
Where Pennsylvania sits
The same service costs 3.4 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· 35th of 51
$107
AK $234KY $69.18
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.