How much rates vary
Facilitymedian $166 · 10th to 90th $50 to $2,570Professionalmedian $78 · 10th to 90th $50 to $138
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 $56.23 Median $660.69 Typical High $6,165.95 | Facility | None | $56.23 | $660.69 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $104.71 | Professional | None | $45.71 | $64.57 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $22.91 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.88 Typical High $15.49 | Professional | 53 · Discontinued | $9.12 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $48.98 Typical High $57.54 | Professional | 54 · Surgery only | $33.88 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.77 Typical High $11.48 | Professional | 55 · Aftercare only | $6.76 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.46 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.57 | $6.46 | $7.76 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $147.91 Typical High $147.91 | Professional | None | $38.02 | $147.91 | $147.91 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $194.98 | Professional | None | $74.13 | $104.71 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $245.47 Typical High $549.54 | Facility | None | $44.67 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $134.90 | Professional | None | $51.29 | $79.43 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $138.04 | Professional | None | $100.00 | $138.04 | $138.04 |
Geisinger Setting Facility Modifier None Typical Low $39.81 Median $50.12 Typical High $87.10 | Facility | None | $39.81 | $50.12 | $87.10 |
Geisinger Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $190.55 | Professional | None | $75.86 | $107.15 | $190.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $338.84 Median $794.33 Typical High $1,380.38 | Facility | None | $338.84 | $794.33 | $1,380.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $97.72 | Professional | None | $77.62 | $83.18 | $97.72 |
Martin's Point Setting Facility Modifier None Typical Low $53.70 Median $1,000.00 Typical High $6,025.60 | Facility | None | $53.70 | $1,000.00 | $6,025.60 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $104.71 | Professional | None | $45.71 | $64.57 | $104.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $22.91 | $32.36 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.88 Typical High $15.49 | Professional | 53 · Discontinued | $9.12 | $12.88 | $15.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $48.98 Typical High $57.54 | Professional | 54 · Surgery only | $33.88 | $48.98 | $57.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.77 Typical High $11.48 | Professional | 55 · Aftercare only | $6.76 | $9.77 | $11.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.46 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.57 | $6.46 | $7.76 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $204.17 | Professional | None | $107.15 | $154.88 | $204.17 |
UPMC Health Plan Setting Facility Modifier None Typical Low $72.44 Median $489.78 Typical High $1,122.02 | Facility | None | $72.44 | $489.78 | $1,122.02 |
UPMC Health Plan Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $109.65 | Professional | None | $51.29 | $77.62 | $109.65 |
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 $54.95 Median $83.18 Typical High $134.90 | Professional | None | $54.95 | $83.18 | $134.90 |
2 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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $158.49 Typical High $288.40 | Professional | 50 · Both sides | $112.20 | $158.49 | $288.40 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $457.09 Median $1,148.15 Typical High $2,041.74 | Facility | 50 · Both sides | $457.09 | $1,148.15 | $2,041.74 |
Where Pennsylvania sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 39th of 51
$77.62
AK $214TX $67.61
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.