How much rates vary
Facilitymedian $398 · 10th to 90th $56 to $2,818Professionalmedian $85 · 10th to 90th $54 to $166
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 $89.13 Median $2,137.96 Typical High $8,317.64 | Facility | None | $89.13 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $107.15 | Professional | None | $48.98 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $23.99 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $15.14 Typical High $17.78 | Professional | 53 · Discontinued | $9.77 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $57.54 Typical High $67.61 | Professional | 54 · Surgery only | $36.31 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $7.24 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.79 | $7.59 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
AmeriHealth Setting Professional Modifier None Typical Low $34.67 Median $46.77 Typical High $85.11 | Professional | None | $34.67 | $46.77 | $85.11 |
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 $85.11 Median $87.10 Typical High $269.15 | Professional | None | $85.11 | $87.10 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $245.47 Typical High $549.54 | Facility | None | $54.95 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $169.82 | Professional | None | $53.70 | $87.10 | $169.82 |
Emblem Health Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | None | $117.49 | $151.36 | $151.36 |
Geisinger Setting Facility Modifier None Typical Low $48.98 Median $61.66 Typical High $107.15 | Facility | None | $48.98 | $61.66 | $107.15 |
Geisinger Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $245.47 | Professional | None | $85.11 | $128.82 | $245.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $43.65 Median $87.10 Typical High $2,187.76 | Facility | None | $43.65 | $87.10 | $2,187.76 |
Highmark BCBS Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $158.49 | Professional | None | $102.33 | $109.65 | $158.49 |
Independence Blue Cross Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $151.36 | Professional | None | $39.81 | $46.77 | $151.36 |
Martin's Point Setting Facility Modifier None Typical Low $323.59 Median $2,137.96 Typical High $7,244.36 | Facility | None | $323.59 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $102.33 | Professional | None | $48.98 | $75.86 | $102.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $23.99 | $38.02 | $44.67 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $15.14 Typical High $17.78 | Professional | 53 · Discontinued | $9.77 | $15.14 | $17.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $57.54 Typical High $67.61 | Professional | 54 · Surgery only | $36.31 | $57.54 | $67.61 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $7.24 | $11.48 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.79 | $7.59 | $8.91 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $269.15 | Professional | None | $107.15 | $154.88 | $269.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $85.11 Median $302.00 Typical High $691.83 | Facility | None | $85.11 | $302.00 | $691.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $204.17 | Professional | None | $54.95 | $93.33 | $204.17 |
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 $57.54 Median $91.20 Typical High $162.18 | Professional | None | $57.54 | $91.20 | $162.18 |
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 $125.89 Median $131.83 Typical High $407.38 | Professional | 50 · Both sides | $125.89 | $131.83 | $407.38 |
Where Pennsylvania sits
The same service costs 3.2 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· 45th of 51
$85.11
AK $224KY $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.