How much rates vary
Facilitymedian $417 · 10th to 90th $51 to $3,020Professionalmedian $79 · 10th to 90th $42 to $162
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 $83.18 Median $2,344.23 Typical High $8,317.64 | Facility | None | $83.18 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $69.18 Typical High $87.10 | Professional | None | $37.15 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $18.62 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.80 Typical High $16.60 | Professional | 53 · Discontinued | $7.41 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $27.54 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $5.62 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.72 | $6.92 | $8.32 |
AmeriHealth Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | None | $85.11 | $85.11 | $89.13 |
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 $77.62 Median $81.28 Typical High $251.19 | Professional | None | $77.62 | $81.28 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $245.47 Typical High $549.54 | Facility | None | $50.12 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $87.10 Typical High $169.82 | Professional | None | $42.66 | $87.10 | $169.82 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $128.82 | Professional | None | $95.50 | $128.82 | $128.82 |
Geisinger Setting Facility Modifier None Typical Low $45.71 Median $56.23 Typical High $100.00 | Facility | None | $45.71 | $56.23 | $100.00 |
Geisinger Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $229.09 | Professional | None | $74.13 | $112.20 | $229.09 |
Independence Blue Cross Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | None | $85.11 | $85.11 | $95.50 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $37.15 Median $69.18 Typical High $87.10 | Professional | None | $37.15 | $69.18 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $18.62 | $34.67 | $41.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.80 Typical High $16.60 | Professional | 53 · Discontinued | $7.41 | $13.80 | $16.60 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $27.54 | $52.48 | $63.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $5.62 | $10.47 | $12.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.72 | $6.92 | $8.32 |
Oscar Health Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $295.12 | Professional | None | $120.23 | $177.83 | $295.12 |
UPMC Health Plan Setting Facility Modifier None Typical Low $77.62 Median $363.08 Typical High $831.76 | Facility | None | $77.62 | $363.08 | $831.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $42.66 Median $95.50 Typical High $162.18 | Professional | None | $42.66 | $95.50 | $162.18 |
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 $44.67 Median $83.18 Typical High $151.36 | Professional | None | $44.67 | $83.18 | $151.36 |
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 $117.49 Median $120.23 Typical High $380.19 | Professional | 50 · Both sides | $117.49 | $120.23 | $380.19 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | 50 · Both sides | $3,311.31 | $3,311.31 | $3,311.31 |
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· 39th of 51
$81.28
AK $191VA $60.26
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.