How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $8,710Professionalmedian $776 · 10th to 90th $603 to $1,349
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 $776.25 Median $3,090.30 Typical High $10,715.19 | Facility | None | $776.25 | $3,090.30 | $10,715.19 |
Aetna Setting Professional Modifier None (both parts) Typical Low $616.60 Median $776.25 Typical High $1,071.52 | Professional | None (both parts) | $616.60 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $257.04 Typical High $323.59 | Professional | 26 · Professional part | $208.93 | $257.04 | $323.59 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $407.38 Median $524.81 Typical High $707.95 | Professional | TC · Technical part | $407.38 | $524.81 | $707.95 |
AmeriHealth Setting Facility Modifier None Typical Low $3,548.13 Median $4,570.88 Typical High $10,964.78 | Facility | None | $3,548.13 | $4,570.88 | $10,964.78 |
AmeriHealth Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 26 · Professional part | $229.09 | $229.09 | $245.47 |
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 $602.56 Median $1,023.29 Typical High $1,412.54 | Professional | None (both parts) | $602.56 | $1,023.29 | $1,412.54 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $223.87 Median $338.84 Typical High $457.09 | Professional | 26 · Professional part | $223.87 | $338.84 | $457.09 |
Capital Blue Cross Setting Professional Modifier TC · Technical part Typical Low $380.19 Median $630.96 Typical High $954.99 | Professional | TC · Technical part | $380.19 | $630.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $794.33 Typical High $7,244.36 | Facility | None | $60.26 | $794.33 | $7,244.36 |
Cigna Setting Professional Modifier None (both parts) Typical Low $602.56 Median $794.33 Typical High $1,318.26 | Professional | None (both parts) | $602.56 | $794.33 | $1,318.26 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $257.04 Typical High $457.09 | Professional | 26 · Professional part | $213.80 | $257.04 | $457.09 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $389.05 Median $537.03 Typical High $870.96 | Professional | TC · Technical part | $389.05 | $537.03 | $870.96 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | None (both parts) | $1,000.00 | $1,000.00 | $1,096.48 |
Geisinger Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $331.13 Median $851.14 Typical High $1,348.96 | Professional | None (both parts) | $331.13 | $851.14 | $1,348.96 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $316.23 Typical High $524.81 | Professional | 26 · Professional part | $239.88 | $316.23 | $524.81 |
Geisinger Setting Professional Modifier TC · Technical part Typical Low $79.43 Median $549.54 Typical High $870.96 | Professional | TC · Technical part | $79.43 | $549.54 | $870.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,918.31 Typical High $10,715.19 | Facility | None | $1,698.24 | $6,918.31 | $10,715.19 |
Independence Blue Cross Setting Facility Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $10,964.78 | Facility | None | $3,235.94 | $4,570.88 | $10,964.78 |
Independence Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 26 · Professional part | $229.09 | $229.09 | $245.47 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $776.25 | $2,818.38 | $10,715.19 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $616.60 Median $776.25 Typical High $1,148.15 | Professional | None (both parts) | $616.60 | $776.25 | $1,148.15 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $257.04 Typical High $323.59 | Professional | 26 · Professional part | $208.93 | $257.04 | $323.59 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $407.38 Median $524.81 Typical High $707.95 | Professional | TC · Technical part | $407.38 | $524.81 | $707.95 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $1,698.24 | Professional | None (both parts) | $398.11 | $398.11 | $1,698.24 |
UPMC Health Plan Setting Facility Modifier None Typical Low $331.13 Median $707.95 Typical High $1,230.27 | Facility | None | $331.13 | $707.95 | $1,230.27 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $331.13 Median $616.60 Typical High $616.60 | Professional | None (both parts) | $331.13 | $616.60 | $616.60 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $218.78 Median $229.09 Typical High $257.04 | Professional | 26 · Professional part | $218.78 | $229.09 | $257.04 |
UPMC Health Plan Setting Professional Modifier TC · Technical part Typical Low $69.18 Median $398.11 Typical High $398.11 | Professional | TC · Technical part | $69.18 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,623.41 | Facility | None | $1,148.15 | $1,905.46 | $5,623.41 |
United Setting Professional Modifier None (both parts) Typical Low $616.60 Median $870.96 Typical High $1,412.54 | Professional | None (both parts) | $616.60 | $870.96 | $1,412.54 |
United Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $309.03 Typical High $467.74 | Professional | 26 · Professional part | $229.09 | $309.03 | $467.74 |
United Setting Professional Modifier TC · Technical part Typical Low $446.68 Median $588.84 Typical High $933.25 | Professional | TC · Technical part | $446.68 | $588.84 | $933.25 |
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 $309.03 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $77.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $346.74 | $389.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $138.04 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $524.81 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $77.62 |
Where Pennsylvania sits
The same service costs 4.4 times more in Wisconsin 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· 32nd of 51
$955
WI $2,630TX $603
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.