How much rates vary
Facilitymedian $251 · 10th to 90th $115 to $5,012Professionalmedian $129 · 10th to 90th $110 to $288
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $109.65 Median $141.25 Typical High $1,862.09 | Facility | None | $109.65 | $141.25 | $1,862.09 |
Aetna Setting Professional Modifier None (both parts) Typical Low $109.65 Median $112.20 Typical High $141.25 | Professional | None (both parts) | $109.65 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | 26 · Professional part | $34.67 | $34.67 | $41.69 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $75.86 Median $75.86 Typical High $97.72 | Professional | TC · Technical part | $75.86 | $75.86 | $97.72 |
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 (both parts) Typical Low $123.03 Median $128.82 Typical High $295.12 | Professional | None (both parts) | $123.03 | $128.82 | $295.12 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $38.02 Typical High $69.18 | Professional | 26 · Professional part | $36.31 | $38.02 | $69.18 |
Capital Blue Cross Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $91.20 Typical High $223.87 | Professional | TC · Technical part | $87.10 | $91.20 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $208.93 Typical High $251.19 | Facility | None | $104.71 | $208.93 | $251.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $169.82 Typical High $295.12 | Professional | None (both parts) | $117.49 | $169.82 | $295.12 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $35.48 Median $39.81 Typical High $63.10 | Professional | 26 · Professional part | $35.48 | $39.81 | $63.10 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $81.28 Median $123.03 Typical High $223.87 | Professional | TC · Technical part | $81.28 | $123.03 | $223.87 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $165.96 Median $213.80 Typical High $239.88 | Professional | None (both parts) | $165.96 | $213.80 | $239.88 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $131.83 Median $218.78 Typical High $436.52 | Professional | None (both parts) | $131.83 | $218.78 | $436.52 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $38.02 Median $50.12 Typical High $89.13 | Professional | 26 · Professional part | $38.02 | $50.12 | $89.13 |
Geisinger Setting Professional Modifier TC · Technical part Typical Low $95.50 Median $158.49 Typical High $380.19 | Professional | TC · Technical part | $95.50 | $158.49 | $380.19 |
Martin's Point Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $1,862.09 | Facility | None | $141.25 | $141.25 | $1,862.09 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | None (both parts) | $109.65 | $109.65 | $141.25 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | 26 · Professional part | $34.67 | $34.67 | $41.69 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $75.86 Median $75.86 Typical High $97.72 | Professional | TC · Technical part | $75.86 | $75.86 | $97.72 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $223.87 Median $316.23 Typical High $489.78 | Professional | None (both parts) | $223.87 | $316.23 | $489.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $251.19 | Facility | None | $114.82 | $251.19 | $251.19 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $114.82 Median $251.19 Typical High $251.19 | Professional | None (both parts) | $114.82 | $251.19 | $251.19 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $34.67 Typical High $35.48 | Professional | 26 · Professional part | $34.67 | $34.67 | $35.48 |
UPMC Health Plan Setting Professional Modifier TC · Technical part Typical Low $79.43 Median $218.78 Typical High $218.78 | Professional | TC · Technical part | $79.43 | $218.78 | $218.78 |
United Setting Facility Modifier None Typical Low $177.83 Median $380.19 Typical High $436.52 | Facility | None | $177.83 | $380.19 | $436.52 |
United Setting Professional Modifier None (both parts) Typical Low $123.03 Median $190.55 Typical High $302.00 | Professional | None (both parts) | $123.03 | $190.55 | $302.00 |
United Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $46.77 Typical High $69.18 | Professional | 26 · Professional part | $34.67 | $46.77 | $69.18 |
United Setting Professional Modifier TC · Technical part Typical Low $93.33 Median $138.04 Typical High $223.87 | Professional | TC · Technical part | $93.33 | $138.04 | $223.87 |
8 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 $54.95 Typical High $69.18 | Professional | 52 · Reduced service | $54.95 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $28.18 | Professional | 53 · Discontinued | $21.88 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $20.89 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $14.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | 52 · Reduced service | $54.95 | $54.95 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $28.18 | Professional | 53 · Discontinued | $21.88 | $21.88 | $28.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $20.89 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $20.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $14.13 |
Where Pennsylvania sits
The same service costs 3.2 times more in Kansas 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· 47th of 51
$129
KS $324UT $100
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.