How much rates vary
Facilitymedian $447 · 10th to 90th $76 to $3,020Professionalmedian $110 · 10th to 90th $87 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 $123.03 Median $2,137.96 Typical High $7,943.28 | Facility | None | $123.03 | $2,137.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $134.90 | Professional | None | $87.10 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $52.48 Typical High $61.66 | Professional | 52 · Reduced service | $43.65 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.89 Typical High $24.55 | Professional | 53 · Discontinued | $17.78 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $66.07 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $13.18 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $10.47 | $12.30 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | None | $109.65 | $117.49 | $117.49 |
AmeriHealth Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $5,248.07 | Facility | None | $524.81 | $707.95 | $5,248.07 |
AmeriHealth Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $117.49 | Professional | None | $58.88 | $93.33 | $117.49 |
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 $109.65 Median $114.82 Typical High $199.53 | Professional | None | $109.65 | $114.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $245.47 Typical High $549.54 | Facility | None | $69.18 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $181.97 | Professional | None | $83.18 | $104.71 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Geisinger Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $134.90 | Facility | None | $61.66 | $77.62 | $134.90 |
Geisinger Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $275.42 | Professional | None | $109.65 | $173.78 | $275.42 |
Highmark BCBS Setting Facility Modifier None Typical Low $102.33 Median $758.58 Typical High $1,905.46 | Facility | None | $102.33 | $758.58 | $1,905.46 |
Highmark BCBS Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $186.21 | Professional | None | $128.82 | $138.04 | $186.21 |
Independence Blue Cross Setting Facility Modifier None Typical Low $446.68 Median $691.83 Typical High $1,698.24 | Facility | None | $446.68 | $691.83 | $1,698.24 |
Independence Blue Cross Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $117.49 | Professional | None | $58.88 | $93.33 | $117.49 |
Martin's Point Setting Facility Modifier None Typical Low $123.03 Median $1,995.26 Typical High $7,244.36 | Facility | None | $123.03 | $1,995.26 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $134.90 | Professional | None | $87.10 | $109.65 | $134.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $43.65 | $53.70 | $61.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $17.78 | $21.88 | $24.55 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $72.44 Typical High $91.20 | Professional | 54 · Surgery only | $66.07 | $72.44 | $91.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $13.18 | $14.79 | $18.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $10.96 | $12.30 |
Oscar Health Setting Facility Modifier None Typical Low $87.10 Median $660.69 Typical High $3,890.45 | Facility | None | $87.10 | $660.69 | $3,890.45 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
UPMC Health Plan Setting Facility Modifier None Typical Low $109.65 Median $512.86 Typical High $954.99 | Facility | None | $109.65 | $512.86 | $954.99 |
UPMC Health Plan Setting Professional Modifier None Typical Low $89.13 Median $186.21 Typical High $512.86 | Professional | None | $89.13 | $186.21 | $512.86 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $194.98 | Professional | None | $93.33 | $112.20 | $194.98 |
3 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 |
|---|---|---|---|---|---|
AmeriHealth Setting Professional Modifier 58 · Staged procedure Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 58 · Staged procedure | $58.88 | $58.88 | $58.88 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $173.78 Typical High $302.00 | Professional | 50 · Both sides | $165.96 | $173.78 | $302.00 |
Highmark BCBS Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $208.93 Typical High $363.08 | Professional | 50 · Both sides | $190.55 | $208.93 | $363.08 |
Where Pennsylvania sits
The same service costs 3.7 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· 46th of 51
$110
AK $363FL $97.72
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.