How much rates vary
Facilitymedian $182 · 10th to 90th $50 to $4,898Professionalmedian $40 · 10th to 90th $32 to $50
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 $40.74 Median $2,818.38 Typical High $8,511.38 | Facility | None | $40.74 | $2,818.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $45.71 | Professional | None | $33.11 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $19.95 Typical High $22.91 | Professional | 52 · Reduced service | $16.22 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.94 Typical High $9.12 | Professional | 53 · Discontinued | $6.61 | $7.94 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $30.20 Typical High $33.88 | Professional | 54 · Surgery only | $24.55 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.03 Typical High $6.76 | Professional | 55 · Aftercare only | $4.90 | $6.03 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.98 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.31 | $3.98 | $4.57 |
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 $40.74 Median $42.66 Typical High $63.10 | Professional | None | $40.74 | $42.66 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $54.95 | Professional | None | $28.84 | $36.31 | $54.95 |
Emblem Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
Geisinger Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $70.79 | Professional | None | $34.67 | $43.65 | $70.79 |
Highmark BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $51.29 | Professional | None | $46.77 | $46.77 | $51.29 |
Martin's Point Setting Facility Modifier None Typical Low $45.71 Median $2,818.38 Typical High $8,511.38 | Facility | None | $45.71 | $2,818.38 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $45.71 | Professional | None | $33.11 | $39.81 | $45.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $19.95 Typical High $22.91 | Professional | 52 · Reduced service | $16.22 | $19.95 | $22.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.94 Typical High $9.12 | Professional | 53 · Discontinued | $6.61 | $7.94 | $9.12 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $30.20 Typical High $33.88 | Professional | 54 · Surgery only | $24.55 | $30.20 | $33.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.03 Typical High $6.76 | Professional | 55 · Aftercare only | $4.90 | $6.03 | $6.76 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.98 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.31 | $3.98 | $4.57 |
Oscar Health Setting Professional Modifier None Typical Low $77.62 Median $208.93 Typical High $208.93 | Professional | None | $77.62 | $208.93 | $208.93 |
UPMC Health Plan Setting Facility Modifier None Typical Low $39.81 Median $1,995.26 Typical High $4,466.84 | Facility | None | $39.81 | $1,995.26 | $4,466.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $50.12 | Professional | None | $32.36 | $41.69 | $50.12 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,445.44 | Facility | None | $77.62 | $158.49 | $1,445.44 |
United Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $61.66 | Professional | None | $31.62 | $39.81 | $61.66 |
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 $61.66 Median $63.10 Typical High $87.10 | Professional | 50 · Both sides | $61.66 | $63.10 | $87.10 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $0.50 Median $1,096.48 Typical High $4,897.79 | Facility | 50 · Both sides | $0.50 | $1,096.48 | $4,897.79 |
Where Pennsylvania sits
The same service costs 3.8 times more in Alaska than in Utah. 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· 42nd of 51
$40.74
AK $135UT $35.48
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.