How much rates vary
Facilitymedian $195 · 10th to 90th $56 to $3,802Professionalmedian $79 · 10th to 90th $46 to $151
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 $50.12 Median $107.15 Typical High $7,244.36 | Facility | None | $50.12 | $107.15 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $125.89 | Professional | None | $41.69 | $70.79 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $66.07 | Professional | None | $60.26 | $64.57 | $66.07 |
AmeriHealth Setting Facility Modifier None Typical Low $660.69 Median $2,344.23 Typical High $3,548.13 | Facility | None | $660.69 | $2,344.23 | $3,548.13 |
AmeriHealth Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $93.33 | Professional | None | $51.29 | $85.11 | $93.33 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $56,234.13 | Facility | None | $3,981.07 | $5,011.87 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $199.53 | Professional | None | $79.43 | $131.83 | $199.53 |
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 $46.77 Median $79.43 Typical High $154.88 | Professional | None | $46.77 | $79.43 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | None | $134.90 | $134.90 | $141.25 |
Geisinger Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $173.78 | Professional | None | $54.95 | $109.65 | $173.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $691.83 | Facility | None | $218.78 | $338.84 | $691.83 |
Independence Blue Cross Setting Facility Modifier None Typical Low $190.55 Median $1,621.81 Typical High $3,548.13 | Facility | None | $190.55 | $1,621.81 | $3,548.13 |
Independence Blue Cross Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $95.50 | Professional | None | $51.29 | $85.11 | $95.50 |
Martin's Point Setting Facility Modifier None Typical Low $50.12 Median $120.23 Typical High $6,606.93 | Facility | None | $50.12 | $120.23 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $131.83 | Professional | None | $41.69 | $70.79 | $131.83 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $245.47 | Professional | None | $89.13 | $93.33 | $245.47 |
UPMC Health Plan Setting Facility Modifier None Typical Low $75.86 Median $141.25 Typical High $309.03 | Facility | None | $75.86 | $141.25 | $309.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $117.49 | Professional | None | $45.71 | $75.86 | $117.49 |
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 $44.67 Median $77.62 Typical High $147.91 | Professional | None | $44.67 | $77.62 | $147.91 |
11 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 $20.89 Median $30.90 Typical High $42.66 | Professional | 52 · Reduced service | $20.89 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.30 Typical High $17.38 | Professional | 53 · Discontinued | $8.32 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $46.77 Typical High $64.57 | Professional | 54 · Surgery only | $31.62 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.33 Typical High $12.88 | Professional | 55 · Aftercare only | $6.31 | $9.33 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.17 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.17 | $6.17 | $8.71 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $194.98 Typical High $295.12 | Professional | 50 · Both sides | $117.49 | $194.98 | $295.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $30.90 Typical High $42.66 | Professional | 52 · Reduced service | $20.89 | $30.90 | $42.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.30 Typical High $17.38 | Professional | 53 · Discontinued | $8.32 | $12.30 | $17.38 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $46.77 Typical High $64.57 | Professional | 54 · Surgery only | $31.62 | $46.77 | $64.57 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.33 Typical High $12.88 | Professional | 55 · Aftercare only | $6.31 | $9.33 | $12.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.17 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.17 | $6.17 | $8.71 |
Where Pennsylvania sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 36th of 51
$85.11
AK $214KY $64.57
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.