How much rates vary
Facilitymedian $1,230 · 10th to 90th $78 to $6,166Professionalmedian $59 · 10th to 90th $51 to $117
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 $64.57 Median $2,344.23 Typical High $8,317.64 | Facility | None | $64.57 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $64.57 | Professional | None | $50.12 | $57.54 | $64.57 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $117.49 | Professional | None | $57.54 | $58.88 | $117.49 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $89.13 Typical High $177.83 | Professional | 50 · Both sides | $85.11 | $89.13 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $109.65 | Professional | None | $48.98 | $58.88 | $109.65 |
Emblem Health Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $100.00 | Professional | None | $79.43 | $91.20 | $100.00 |
Geisinger Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $141.25 | Professional | None | $56.23 | $70.79 | $141.25 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $64.57 | Professional | None | $50.12 | $57.54 | $64.57 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $229.09 Typical High $467.74 | Professional | None | $100.00 | $229.09 | $467.74 |
UPMC Health Plan Setting Facility Modifier None Typical Low $56.23 Median $309.03 Typical High $562.34 | Facility | None | $56.23 | $309.03 | $562.34 |
UPMC Health Plan Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $562.34 | Professional | None | $50.12 | $77.62 | $562.34 |
United Setting Facility Modifier None Typical Low $169.82 Median $524.81 Typical High $3,890.45 | Facility | None | $169.82 | $524.81 | $3,890.45 |
United Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $123.03 | Professional | None | $52.48 | $67.61 | $123.03 |
10 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $28.84 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.48 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $43.65 Typical High $48.98 | Professional | 54 · Surgery only | $38.02 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.71 Typical High $9.77 | Professional | 55 · Aftercare only | $7.59 | $8.71 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.75 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $5.75 | $6.46 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $28.84 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $28.84 | $32.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.48 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $11.48 | $12.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $43.65 Typical High $48.98 | Professional | 54 · Surgery only | $38.02 | $43.65 | $48.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.71 Typical High $9.77 | Professional | 55 · Aftercare only | $7.59 | $8.71 | $9.77 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.75 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $5.75 | $6.46 |
Where Pennsylvania sits
The same service costs 3.4 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· 47th of 51
$58.88
AK $182FL $53.70
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.