Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.
| Insurance Carrier | Facility/Professional | Modifier | Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. | MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. | Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier Global Typical Low $1,412.54 Median $6,025.60 Typical High $10,471.29 | Facility | Global | $1,412.54 | $6,025.60 | $10,471.29 |
Aetna Setting Facility Modifier 50 · Both sides Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | 50 · Both sides | $5,128.61 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier Global Typical Low $691.83 Median $954.99 Typical High $3,467.37 | Professional | Global | $691.83 | $954.99 | $3,467.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $724.44 Typical High $1,071.52 | Professional | 54 · Surgery only | $316.23 | $724.44 | $1,071.52 |
Ambetter Setting Professional Modifier Global Typical Low $616.60 Median $691.83 Typical High $1,122.02 | Professional | Global | $616.60 | $691.83 | $1,122.02 |
AmeriHealth Setting Facility Modifier Global Typical Low $6,456.54 Median $10,000.00 Typical High $21,379.62 | Facility | Global | $6,456.54 | $10,000.00 | $21,379.62 |
AmeriHealth Setting Professional Modifier Global Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | Global | $758.58 | $758.58 | $758.58 |
Capital Blue Cross Setting Facility Modifier Global Typical Low $6,456.54 Median $6,606.93 Typical High $57,543.99 | Facility | Global | $6,456.54 | $6,606.93 | $57,543.99 |
Capital Blue Cross Setting Professional Modifier Global Typical Low $724.44 Median $1,096.48 Typical High $1,905.46 | Professional | Global | $724.44 | $1,096.48 | $1,905.46 |
Cigna Setting Facility Modifier Global Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | Global | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier Global Typical Low $562.34 Median $977.24 Typical High $1,479.11 | Professional | Global | $562.34 | $977.24 | $1,479.11 |
Emblem Health Setting Professional Modifier Global Typical Low $524.81 Median $758.58 Typical High $1,047.13 | Professional | Global | $524.81 | $758.58 | $1,047.13 |
Geisinger Setting Professional Modifier Global Typical Low $630.96 Median $912.01 Typical High $1,348.96 | Professional | Global | $630.96 | $912.01 | $1,348.96 |
Geisinger Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $870.96 Typical High $1,000.00 | Professional | 55 · Aftercare only | $691.83 | $870.96 | $1,000.00 |
Highmark BCBS Setting Facility Modifier Global Typical Low $3,090.30 Median $4,677.35 Typical High $8,128.31 | Facility | Global | $3,090.30 | $4,677.35 | $8,128.31 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $33,113.11 Median $33,113.11 Typical High $33,113.11 | Facility | 50 · Both sides | $33,113.11 | $33,113.11 | $33,113.11 |
Highmark BCBS Setting Professional Modifier Global Typical Low $831.76 Median $912.01 Typical High $1,288.25 | Professional | Global | $831.76 | $912.01 | $1,288.25 |
Highmark BCBS Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $630.96 | $660.69 |
Highmark BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $181.97 Typical High $223.87 | Professional | 55 · Aftercare only | $165.96 | $181.97 | $223.87 |
Independence Blue Cross Setting Facility Modifier Global Typical Low $2,630.27 Median $7,585.78 Typical High $10,964.78 | Facility | Global | $2,630.27 | $7,585.78 | $10,964.78 |
Independence Blue Cross Setting Professional Modifier Global Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | Global | $758.58 | $758.58 | $758.58 |
Martin's Point Setting Facility Modifier Global Typical Low $794.33 Median $4,897.79 Typical High $8,709.64 | Facility | Global | $794.33 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier Global Typical Low $707.95 Median $912.01 Typical High $1,698.24 | Professional | Global | $707.95 | $912.01 | $1,698.24 |
Oscar Health Setting Facility Modifier Global Typical Low $1,905.46 Median $2,398.83 Typical High $5,754.40 | Facility | Global | $1,905.46 | $2,398.83 | $5,754.40 |
Oscar Health Setting Professional Modifier Global Typical Low $1,023.29 Median $1,071.52 Typical High $1,862.09 | Professional | Global | $1,023.29 | $1,071.52 | $1,862.09 |
UPMC Health Plan Setting Facility Modifier Global Typical Low $537.03 Median $537.03 Typical High $1,148.15 | Facility | Global | $537.03 | $537.03 | $1,148.15 |
UPMC Health Plan Setting Professional Modifier Global Typical Low $537.03 Median $707.95 Typical High $1,148.15 | Professional | Global | $537.03 | $707.95 | $1,148.15 |
United Setting Facility Modifier Global Typical Low $1,737.80 Median $3,890.45 Typical High $7,413.10 | Facility | Global | $1,737.80 | $3,890.45 | $7,413.10 |
United Setting Professional Modifier Global Typical Low $630.96 Median $851.14 Typical High $1,479.11 | Professional | Global | $630.96 | $851.14 | $1,479.11 |