How much rates vary
Facilitymedian $93 · 10th to 90th $37 to $2,818Professionalmedian $60 · 10th to 90th $46 to $83
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 $60.26 Median $3,630.78 Typical High $8,511.38 | Facility | None | $60.26 | $3,630.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $67.61 | Professional | None | $45.71 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $30.20 Typical High $33.11 | Professional | 52 · Reduced service | $22.91 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.02 Typical High $13.49 | Professional | 53 · Discontinued | $9.12 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $44.67 Typical High $50.12 | Professional | 54 · Surgery only | $34.67 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.91 Typical High $10.00 | Professional | 55 · Aftercare only | $6.92 | $8.91 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.03 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.57 | $6.03 | $6.76 |
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 $61.66 Median $64.57 Typical High $97.72 | Professional | None | $61.66 | $64.57 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $100.00 | Facility | None | $33.11 | $50.12 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $81.28 | Professional | None | $42.66 | $53.70 | $81.28 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Geisinger Setting Facility Modifier None Typical Low $31.62 Median $39.81 Typical High $70.79 | Facility | None | $31.62 | $39.81 | $70.79 |
Geisinger Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $123.03 | Professional | None | $53.70 | $66.07 | $123.03 |
Martin's Point Setting Facility Modifier None Typical Low $67.61 Median $3,630.78 Typical High $8,709.64 | Facility | None | $67.61 | $3,630.78 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $67.61 | Professional | None | $45.71 | $60.26 | $67.61 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $30.20 Typical High $33.11 | Professional | 52 · Reduced service | $22.91 | $30.20 | $33.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.02 Typical High $13.49 | Professional | 53 · Discontinued | $9.12 | $12.02 | $13.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $44.67 Typical High $50.12 | Professional | 54 · Surgery only | $34.67 | $44.67 | $50.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.91 Typical High $10.00 | Professional | 55 · Aftercare only | $6.92 | $8.91 | $10.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.03 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.57 | $6.03 | $6.76 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | None | $204.17 | $223.87 | $223.87 |
UPMC Health Plan Setting Facility Modifier None Typical Low $60.26 Median $416.87 Typical High $954.99 | Facility | None | $60.26 | $416.87 | $954.99 |
UPMC Health Plan Setting Professional Modifier None Typical Low $45.71 Median $83.18 Typical High $302.00 | Professional | None | $45.71 | $83.18 | $302.00 |
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 $46.77 Median $58.88 Typical High $93.33 | Professional | None | $46.77 | $58.88 | $93.33 |
2 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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $95.50 Typical High $128.82 | Professional | 50 · Both sides | $93.33 | $95.50 | $128.82 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | 50 · Both sides | $199.53 | $199.53 | $199.53 |
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· 44th of 51
$60.26
AK $191FL $51.29
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.