How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,380 to $10,471Professionalmedian $389 · 10th to 90th $269 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 $7,413.10 Typical High $11,748.98 | Facility | None | $1,445.44 | $7,413.10 | $11,748.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $707.95 Median $2,290.87 Typical High $8,317.64 | Professional | None (both parts) | $707.95 | $2,290.87 | $8,317.64 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | 26 · Professional part | $251.19 | $281.84 | $302.00 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $263.03 Typical High $467.74 | Professional | 26 · Professional part | $257.04 | $263.03 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $4,365.16 Median $5,370.32 Typical High $7,244.36 | Facility | None | $4,365.16 | $5,370.32 | $7,244.36 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $302.00 Typical High $537.03 | Professional | 26 · Professional part | $245.47 | $302.00 | $537.03 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None (both parts) | $4,466.84 | $4,466.84 | $4,466.84 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None (both parts) | $323.59 | $323.59 | $323.59 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $275.42 Median $363.08 Typical High $549.54 | Professional | 26 · Professional part | $275.42 | $363.08 | $549.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.50 Median $0.50 Typical High $7,079.46 | Facility | None | $0.50 | $0.50 | $7,079.46 |
Martin's Point Setting Facility Modifier None Typical Low $1,513.56 Median $6,606.93 Typical High $12,589.25 | Facility | None | $1,513.56 | $6,606.93 | $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 $251.19 Median $281.84 Typical High $302.00 | Professional | 26 · Professional part | $251.19 | $281.84 | $302.00 |
UPMC Health Plan Setting Facility Modifier 26 · Professional part Typical Low $257.04 Median $295.12 Typical High $295.12 | Facility | 26 · Professional part | $257.04 | $295.12 | $295.12 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $269.15 Typical High $295.12 | Professional | 26 · Professional part | $257.04 | $269.15 | $295.12 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,309.57 | Facility | None | $1,380.38 | $2,398.83 | $6,309.57 |
United Setting Professional Modifier None (both parts) Typical Low $269.15 Median $371.54 Typical High $562.34 | Professional | None (both parts) | $269.15 | $371.54 | $562.34 |
United Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $371.54 Typical High $562.34 | Professional | 26 · Professional part | $269.15 | $371.54 | $562.34 |
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 $125.89 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $125.89 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $50.12 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.18 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.12 | $28.18 | $30.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $125.89 | $141.25 | $151.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $50.12 | $56.23 | $60.26 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $213.80 | $223.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $45.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.18 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.12 | $28.18 | $30.20 |
Where Pennsylvania sits
The same service costs 19.5 times more in Colorado 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.
Pennsylvania· 20th of 51
$1,862
CO $6,761MD $347
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.