How much rates vary
Facilitymedian $759 · 10th to 90th $162 to $6,166Professionalmedian $224 · 10th to 90th $120 to $468
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 $245.47 Median $4,897.79 Typical High $8,511.38 | Facility | None | $245.47 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $323.59 | Professional | None | $109.65 | $204.17 | $323.59 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $407.38 | Professional | None | $218.78 | $323.59 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $588.84 Typical High $1,513.56 | Facility | None | $158.49 | $588.84 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $691.83 | Professional | None | $120.23 | $218.78 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | None | $363.08 | $363.08 | $380.19 |
Geisinger Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $316.23 | Facility | None | $141.25 | $177.83 | $316.23 |
Geisinger Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $912.01 | Professional | None | $218.78 | $354.81 | $912.01 |
Highmark BCBS Setting Facility Modifier None Typical Low $194.98 Median $3,801.89 Typical High $7,244.36 | Facility | None | $194.98 | $3,801.89 | $7,244.36 |
Martin's Point Setting Facility Modifier None Typical Low $245.47 Median $4,677.35 Typical High $8,709.64 | Facility | None | $245.47 | $4,677.35 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $323.59 | Professional | None | $109.65 | $204.17 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $776.25 Typical High $1,479.11 | Professional | None | $269.15 | $776.25 | $1,479.11 |
UPMC Health Plan Setting Facility Modifier None Typical Low $223.87 Median $1,819.70 Typical High $4,265.80 | Facility | None | $223.87 | $1,819.70 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $123.03 Median $275.42 Typical High $776.25 | Professional | None | $123.03 | $275.42 | $776.25 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,467.37 | Facility | None | $416.87 | $724.44 | $3,467.37 |
United Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $457.09 | Professional | None | $117.49 | $208.93 | $457.09 |
12 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 $54.95 Median $97.72 Typical High $123.03 | Professional | 52 · Reduced service | $54.95 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $147.91 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.96 | $19.95 | $24.55 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $478.63 Typical High $602.56 | Professional | 50 · Both sides | $331.13 | $478.63 | $602.56 |
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | GC · Resident with teaching physician | $794.33 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $97.72 Typical High $123.03 | Professional | 52 · Reduced service | $54.95 | $97.72 | $123.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $39.81 | $48.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $147.91 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $147.91 | $186.21 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $29.51 | $37.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.96 | $19.95 | $24.55 |
Where Pennsylvania sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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
$240
OK $692TX $214
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.