How much rates vary
Facilitymedian $214 · 10th to 90th $65 to $4,266Professionalmedian $110 · 10th to 90th $91 to $148
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 $112.20 Median $3,630.78 Typical High $8,511.38 | Facility | None | $112.20 | $3,630.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $123.03 | Professional | None | $97.72 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $48.98 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $19.50 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $72.44 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $12.30 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $112.20 Median $117.49 Typical High $173.78 | Professional | None | $112.20 | $117.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $151.36 | Professional | None | $87.10 | $97.72 | $151.36 |
Emblem Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
Geisinger Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $213.80 | Professional | None | $100.00 | $123.03 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $158.49 | Professional | None | $123.03 | $138.04 | $158.49 |
Martin's Point Setting Facility Modifier None Typical Low $123.03 Median $3,630.78 Typical High $8,709.64 | Facility | None | $123.03 | $3,630.78 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $123.03 | Professional | None | $97.72 | $109.65 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $48.98 | $54.95 | $61.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $19.50 | $21.88 | $24.55 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $72.44 | $83.18 | $93.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $18.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $12.30 |
Oscar Health Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $275.42 | Professional | None | $208.93 | $275.42 | $275.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $109.65 Median $288.40 Typical High $436.52 | Facility | None | $109.65 | $288.40 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $363.08 | Professional | None | $97.72 | $131.83 | $363.08 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,445.44 | Facility | None | $77.62 | $158.49 | $1,445.44 |
United Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $181.97 | Professional | None | $89.13 | $117.49 | $181.97 |
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 $169.82 Median $177.83 Typical High $239.88 | Professional | 50 · Both sides | $169.82 | $177.83 | $239.88 |
Where Pennsylvania sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 44th of 51
$112
AK $407FL $91.20
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.