How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,413 to $10,471Professionalmedian $1,175 · 10th to 90th $407 to $1,820
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 $6,606.93 Typical High $11,748.98 | Facility | None | $1,445.44 | $6,606.93 | $11,748.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,318.26 Typical High $1,548.82 | Professional | None (both parts) | $1,174.90 | $1,318.26 | $1,548.82 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $346.74 Typical High $363.08 | Professional | 26 · Professional part | $302.00 | $346.74 | $363.08 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $331.13 Typical High $575.44 | Professional | 26 · Professional part | $316.23 | $331.13 | $575.44 |
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 None (both parts) Typical Low $1,174.90 Median $1,412.54 Typical High $2,511.89 | Professional | None (both parts) | $1,174.90 | $1,412.54 | $2,511.89 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $309.03 Median $371.54 Typical High $660.69 | Professional | 26 · Professional part | $309.03 | $371.54 | $660.69 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None (both parts) | $1,949.84 | $1,949.84 | $1,949.84 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None (both parts) | $389.05 | $389.05 | $389.05 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $338.84 Median $436.52 Typical High $676.08 | Professional | 26 · Professional part | $338.84 | $436.52 | $676.08 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $7,079.46 Typical High $14,791.08 | Facility | None | $1,949.84 | $7,079.46 | $14,791.08 |
Martin's Point Setting Facility Modifier None Typical Low $1,513.56 Median $6,165.95 Typical High $12,589.25 | Facility | None | $1,513.56 | $6,165.95 | $12,589.25 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,318.26 Typical High $1,513.56 | Professional | None (both parts) | $1,174.90 | $1,318.26 | $1,513.56 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $346.74 Typical High $363.08 | Professional | 26 · Professional part | $302.00 | $346.74 | $363.08 |
UPMC Health Plan Setting Facility Modifier 26 · Professional part Typical Low $316.23 Median $354.81 Typical High $354.81 | Facility | 26 · Professional part | $316.23 | $354.81 | $354.81 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $323.59 Typical High $354.81 | Professional | 26 · Professional part | $316.23 | $323.59 | $354.81 |
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 $338.84 Median $446.68 Typical High $1,202.26 | Professional | None (both parts) | $338.84 | $446.68 | $1,202.26 |
United Setting Professional Modifier 26 · Professional part Typical Low $323.59 Median $446.68 Typical High $676.08 | Professional | 26 · Professional part | $323.59 | $446.68 | $676.08 |
13 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 $588.84 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $870.96 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $151.36 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $870.96 Median $977.24 Typical High $1,148.15 | Professional | TC · Technical part | $870.96 | $977.24 | $1,148.15 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $870.96 Median $1,047.13 Typical High $1,862.09 | Professional | TC · Technical part | $870.96 | $1,047.13 | $1,862.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $660.69 | $741.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $263.03 | $302.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $870.96 | $1,000.00 | $1,122.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $199.53 | $223.87 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $151.36 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $870.96 Median $977.24 Typical High $1,148.15 | Professional | TC · Technical part | $870.96 | $977.24 | $1,148.15 |
Where Pennsylvania sits
The same service costs 14.5 times more in California than in Maine. 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· 35th of 51
$1,514
CA $8,128ME $562
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.