How much rates vary
Facilitymedian $4,898 · 10th to 90th $646 to $16,596Professionalmedian $661 · 10th to 90th $537 to $1,122
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 $645.65 Median $5,370.32 Typical High $10,000.00 | Facility | None | $645.65 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | None | $537.03 | $645.65 | $645.65 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,148.15 | Professional | None | $645.65 | $660.69 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $16,595.87 | Facility | None | $501.19 | $2,691.53 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,174.90 | Professional | None | $575.44 | $691.83 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | None | $891.25 | $891.25 | $954.99 |
Geisinger Setting Facility Modifier None Typical Low $10,000.00 Median $12,589.25 Typical High $21,877.62 | Facility | None | $10,000.00 | $12,589.25 | $21,877.62 |
Geisinger Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,148.15 | Professional | None | $575.44 | $724.44 | $1,148.15 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $4,897.79 Typical High $10,000.00 | Facility | None | $724.44 | $4,897.79 | $10,000.00 |
Martin's Point Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | None | $537.03 | $645.65 | $645.65 |
Oscar Health Setting Professional Modifier None Typical Low $5.01 Median $724.44 Typical High $2,570.40 | Professional | None | $5.01 | $724.44 | $2,570.40 |
UPMC Health Plan Setting Facility Modifier None Typical Low $630.96 Median $660.69 Typical High $660.69 | Facility | None | $630.96 | $660.69 | $660.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | None | $630.96 | $660.69 | $660.69 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,698.24 | $3,235.94 | $10,715.19 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,258.93 | Professional | None | $588.84 | $741.31 | $1,258.93 |
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 $269.15 Median $316.23 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $125.89 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $63.10 | $64.57 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $316.23 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $316.23 | $323.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $125.89 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $125.89 | $128.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $81.28 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $63.10 | $64.57 |
Where Pennsylvania sits
The same service costs 11.7 times more in Oklahoma 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· 43rd of 51
$692
OK $4,786UT $407
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.