How much rates vary
Facilitymedian $95 · 10th to 90th $43 to $2,818Professionalmedian $74 · 10th to 90th $60 to $93
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 $66.07 Median $3,630.78 Typical High $8,511.38 | Facility | None | $66.07 | $3,630.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $81.28 | Professional | None | $60.26 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $36.31 Typical High $40.74 | Professional | 52 · Reduced service | $30.20 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $16.22 | Professional | 53 · Discontinued | $12.30 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $53.70 Typical High $61.66 | Professional | 54 · Surgery only | $45.71 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.96 Typical High $12.30 | Professional | 55 · Aftercare only | $9.12 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.24 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.03 | $7.24 | $8.13 |
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 $75.86 Median $79.43 Typical High $112.20 | Professional | None | $75.86 | $79.43 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $54.95 Typical High $100.00 | Facility | None | $38.90 | $54.95 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $100.00 | Professional | None | $57.54 | $72.44 | $100.00 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $131.83 | Professional | None | $95.50 | $95.50 | $131.83 |
Geisinger Setting Facility Modifier None Typical Low $37.15 Median $45.71 Typical High $81.28 | Facility | None | $37.15 | $45.71 | $81.28 |
Geisinger Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $138.04 | Professional | None | $54.95 | $83.18 | $138.04 |
Highmark BCBS Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Martin's Point Setting Facility Modifier None Typical Low $81.28 Median $3,630.78 Typical High $8,709.64 | Facility | None | $81.28 | $3,630.78 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $81.28 | Professional | None | $60.26 | $72.44 | $81.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $36.31 Typical High $40.74 | Professional | 52 · Reduced service | $30.20 | $36.31 | $40.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $16.22 | Professional | 53 · Discontinued | $12.30 | $14.45 | $16.22 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $53.70 Typical High $61.66 | Professional | 54 · Surgery only | $45.71 | $53.70 | $61.66 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.96 Typical High $12.30 | Professional | 55 · Aftercare only | $9.12 | $10.96 | $12.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.24 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.03 | $7.24 | $8.13 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | None | $125.89 | $125.89 | $131.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $69.18 Median $199.53 Typical High $457.09 | Facility | None | $69.18 | $199.53 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $75.86 | Professional | None | $61.66 | $72.44 | $75.86 |
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 $58.88 Median $70.79 Typical High $112.20 | Professional | None | $58.88 | $70.79 | $112.20 |
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 $114.82 Median $117.49 Typical High $165.96 | Professional | 50 · Both sides | $114.82 | $117.49 | $165.96 |
Where Pennsylvania sits
The same service costs 3.8 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· 43rd of 51
$74.13
AK $257FL $67.61
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.