How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,047 to $10,715Professionalmedian $275 · 10th to 90th $191 to $955
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 $1,445.44 Median $7,244.36 Typical High $12,302.69 | Facility | None | $1,445.44 | $7,244.36 | $12,302.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $1,584.89 Typical High $8,317.64 | Professional | None (both parts) | $177.83 | $1,584.89 | $8,317.64 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $199.53 Typical High $208.93 | Professional | 26 · Professional part | $177.83 | $199.53 | $208.93 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $186.21 Median $194.98 Typical High $331.13 | Professional | 26 · Professional part | $186.21 | $194.98 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $794.33 Typical High $7,585.78 | Facility | None | $60.26 | $794.33 | $7,585.78 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $218.78 Typical High $380.19 | Professional | 26 · Professional part | $177.83 | $218.78 | $380.19 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None (both parts) | $588.84 | $588.84 | $588.84 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None (both parts) | $223.87 | $223.87 | $223.87 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $199.53 Median $257.04 Typical High $398.11 | Professional | 26 · Professional part | $199.53 | $257.04 | $398.11 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $6,760.83 Typical High $9,120.11 | Facility | None | $1,122.02 | $6,760.83 | $9,120.11 |
Martin's Point Setting Facility Modifier None Typical Low $1,513.56 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,513.56 | $6,456.54 | $12,589.25 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $707.95 Median $2,454.71 Typical High $8,912.51 | Professional | None (both parts) | $707.95 | $2,454.71 | $8,912.51 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $199.53 Typical High $208.93 | Professional | 26 · Professional part | $177.83 | $199.53 | $208.93 |
UPMC Health Plan Setting Facility Modifier 26 · Professional part Typical Low $181.97 Median $208.93 Typical High $208.93 | Facility | 26 · Professional part | $181.97 | $208.93 | $208.93 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $190.55 Typical High $208.93 | Professional | 26 · Professional part | $181.97 | $190.55 | $208.93 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $10,471.29 | Facility | None | $2,818.38 | $5,495.41 | $10,471.29 |
United Setting Professional Modifier None (both parts) Typical Low $186.21 Median $263.03 Typical High $389.05 | Professional | None (both parts) | $186.21 | $263.03 | $389.05 |
United Setting Professional Modifier 26 · Professional part Typical Low $186.21 Median $263.03 Typical High $389.05 | Professional | 26 · Professional part | $186.21 | $263.03 | $389.05 |
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 $89.13 Median $100.00 Typical High $104.71 | Professional | 52 · Reduced service | $89.13 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $147.91 Typical High $158.49 | Professional | 54 · Surgery only | $131.83 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $20.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $100.00 Typical High $104.71 | Professional | 52 · Reduced service | $89.13 | $100.00 | $104.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $39.81 | $42.66 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $147.91 Typical High $158.49 | Professional | 54 · Surgery only | $131.83 | $147.91 | $158.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $31.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $20.89 |
Where Pennsylvania sits
The same service costs 28.8 times more in Colorado than in Kentucky. 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· 11th of 51
$3,090
CO $7,079KY $245
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.