How much rates vary
Facilitymedian $380 · 10th to 90th $87 to $2,818Professionalmedian $107 · 10th to 90th $52 to $186
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 $1,148.15 Typical High $6,165.95 | Facility | None | $74.13 | $1,148.15 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $131.83 | Professional | None | $46.77 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $47.86 Typical High $57.54 | Professional | 52 · Reduced service | $23.44 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $19.05 Typical High $22.91 | Professional | 53 · Discontinued | $9.33 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $72.44 Typical High $85.11 | Professional | 54 · Surgery only | $35.48 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $14.45 Typical High $16.98 | Professional | 55 · Aftercare only | $7.08 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $4.68 | $9.55 | $11.48 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $107.15 Median $109.65 Typical High $257.04 | Professional | None | $107.15 | $109.65 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $245.47 Typical High $549.54 | Facility | None | $91.20 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $104.71 Typical High $177.83 | Professional | None | $52.48 | $104.71 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $204.17 | Professional | None | $154.88 | $204.17 | $204.17 |
Geisinger Setting Facility Modifier None Typical Low $83.18 Median $104.71 Typical High $181.97 | Facility | None | $83.18 | $104.71 | $181.97 |
Geisinger Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $269.15 | Professional | None | $107.15 | $147.91 | $269.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $407.38 Median $1,819.70 Typical High $4,073.80 | Facility | None | $407.38 | $1,819.70 | $4,073.80 |
Martin's Point Setting Facility Modifier None Typical Low $83.18 Median $1,445.44 Typical High $6,165.95 | Facility | None | $83.18 | $1,445.44 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $114.82 | Professional | None | $46.77 | $95.50 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $47.86 Typical High $57.54 | Professional | 52 · Reduced service | $23.44 | $47.86 | $57.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $19.05 Typical High $22.91 | Professional | 53 · Discontinued | $9.33 | $19.05 | $22.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $72.44 Typical High $85.11 | Professional | 54 · Surgery only | $35.48 | $72.44 | $85.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $14.45 Typical High $16.98 | Professional | 55 · Aftercare only | $7.08 | $14.45 | $16.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $4.68 | $9.55 | $11.48 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $257.04 | Professional | None | $131.83 | $169.82 | $257.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $93.33 Median $302.00 Typical High $691.83 | Facility | None | $93.33 | $302.00 | $691.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $53.70 Median $107.15 Typical High $147.91 | Professional | None | $53.70 | $107.15 | $147.91 |
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 $109.65 Typical High $177.83 | Professional | None | $57.54 | $109.65 | $177.83 |
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 $158.49 Median $165.96 Typical High $380.19 | Professional | 50 · Both sides | $158.49 | $165.96 | $380.19 |
Where Pennsylvania sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 41st of 51
$107
AK $263VA $81.28
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.