How much rates vary
Facilitymedian $240 · 10th to 90th $31 to $2,818Professionalmedian $55 · 10th to 90th $46 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 $56.23 Median $2,137.96 Typical High $8,317.64 | Facility | None | $56.23 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $91.20 | Professional | None | $45.71 | $51.29 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $25.12 Typical High $28.18 | Professional | 52 · Reduced service | $22.91 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.00 Typical High $11.22 | Professional | 53 · Discontinued | $9.12 | $10.00 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $38.02 Typical High $42.66 | Professional | 54 · Surgery only | $33.88 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.59 Typical High $8.51 | Professional | 55 · Aftercare only | $6.76 | $7.59 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.01 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.57 | $5.01 | $5.62 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | None | $50.12 | $53.70 | $53.70 |
AmeriHealth Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $8,709.64 | Facility | None | $2,511.89 | $2,570.40 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $81.28 | Professional | None | $50.12 | $52.48 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $245.47 Typical High $549.54 | Facility | None | $27.54 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $66.07 Typical High $100.00 | Professional | None | $38.90 | $66.07 | $100.00 |
Emblem Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Geisinger Setting Facility Modifier None Typical Low $24.55 Median $30.90 Typical High $53.70 | Facility | None | $24.55 | $30.90 | $53.70 |
Geisinger Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $120.23 | Professional | None | $45.71 | $69.18 | $120.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $6,760.83 | Facility | None | $204.17 | $229.09 | $6,760.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $81.28 | Professional | None | $57.54 | $61.66 | $81.28 |
Independence Blue Cross Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Martin's Point Setting Facility Modifier None Typical Low $102.33 Median $2,137.96 Typical High $7,244.36 | Facility | None | $102.33 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $87.10 | Professional | None | $45.71 | $50.12 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $25.12 Typical High $28.18 | Professional | 52 · Reduced service | $22.91 | $25.12 | $28.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.00 Typical High $11.22 | Professional | 53 · Discontinued | $9.12 | $10.00 | $11.22 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $38.02 Typical High $42.66 | Professional | 54 · Surgery only | $33.88 | $38.02 | $42.66 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.59 Typical High $8.51 | Professional | 55 · Aftercare only | $6.76 | $7.59 | $8.51 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.01 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.57 | $5.01 | $5.62 |
Oscar Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | None | $61.66 | $61.66 | $66.07 |
UPMC Health Plan Setting Facility Modifier None Typical Low $50.12 Median $199.53 Typical High $457.09 | Facility | None | $50.12 | $199.53 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $81.28 | Professional | None | $45.71 | $63.10 | $81.28 |
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 $54.95 Median $67.61 Typical High $102.33 | Professional | None | $54.95 | $67.61 | $102.33 |
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 $75.86 Median $77.62 Typical High $123.03 | Professional | 50 · Both sides | $75.86 | $77.62 | $123.03 |
Where Pennsylvania sits
The same service costs 3.6 times more in Wyoming 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· 49th of 51
$56.23
WY $191FL $52.48
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.