How much rates vary
Facilitymedian $977 · 10th to 90th $83 to $8,511Professionalmedian $490 · 10th to 90th $363 to $813
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 $660.69 Median $2,818.38 Typical High $10,000.00 | Facility | None | $660.69 | $2,818.38 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $660.69 | Professional | None | $363.08 | $436.52 | $660.69 |
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 Typical Low $380.19 Median $660.69 Typical High $891.25 | Professional | None | $380.19 | $660.69 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $6,760.83 Median $8,511.38 Typical High $11,748.98 | Facility | None | $6,760.83 | $8,511.38 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $794.33 | Professional | None | $363.08 | $501.19 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | None | $478.63 | $478.63 | $537.03 |
Geisinger Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $831.76 | Professional | None | $363.08 | $501.19 | $831.76 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $10,000.00 | Facility | None | $724.44 | $2,818.38 | $10,000.00 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $501.19 | Professional | None | $363.08 | $436.52 | $501.19 |
UPMC Health Plan Setting Facility Modifier None Typical Low $380.19 Median $489.78 Typical High $489.78 | Facility | None | $380.19 | $489.78 | $489.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $489.78 | Professional | None | $380.19 | $389.05 | $489.78 |
United Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $1,230.27 | Facility | None | $70.79 | $141.25 | $1,230.27 |
United Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $812.83 | Professional | None | $389.05 | $537.03 | $812.83 |
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 $181.97 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $181.97 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $275.42 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $181.97 | $204.17 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $83.18 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $275.42 | $309.03 | $331.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $43.65 |
Where Pennsylvania sits
The same service costs 27.0 times more in Alabama than in Maryland. 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.
Physician feeFacility fee
AL $15,422MD $571
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.