How much rates vary
Facilitymedian $603 · 10th to 90th $78 to $6,607Professionalmedian $617 · 10th to 90th $479 to $1,230
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 $602.56 Median $3,801.89 Typical High $8,511.38 | Facility | None | $602.56 | $3,801.89 | $8,511.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $478.63 Median $549.54 Typical High $602.56 | Professional | None (both parts) | $478.63 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $363.08 Median $416.87 Typical High $446.68 | Professional | 26 · Professional part | $363.08 | $416.87 | $446.68 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $138.04 Typical High $154.88 | Professional | TC · Technical part | $117.49 | $138.04 | $154.88 |
Capital Blue Cross Setting Facility Modifier None Typical Low $8,709.64 Median $47,863.01 Typical High $56,234.13 | Facility | None | $8,709.64 | $47,863.01 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None (both parts) Typical Low $56,234.13 Median $56,234.13 Typical High $56,234.13 | Professional | None (both parts) | $56,234.13 | $56,234.13 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $380.19 Median $602.56 Typical High $776.25 | Professional | 26 · Professional part | $380.19 | $602.56 | $776.25 |
Capital Blue Cross Setting Professional Modifier TC · Technical part Typical Low $275.42 Median $302.00 Typical High $524.81 | Professional | TC · Technical part | $275.42 | $302.00 | $524.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $489.78 Median $602.56 Typical High $1,047.13 | Professional | None (both parts) | $489.78 | $602.56 | $1,047.13 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $371.54 Median $446.68 Typical High $794.33 | Professional | 26 · Professional part | $371.54 | $446.68 | $794.33 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $154.88 Typical High $281.84 | Professional | TC · Technical part | $117.49 | $154.88 | $281.84 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $1,174.90 Median $1,174.90 Typical High $10,471.29 | Professional | None (both parts) | $1,174.90 | $1,174.90 | $10,471.29 |
Geisinger Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $676.08 Median $691.83 Typical High $1,819.70 | Professional | None (both parts) | $676.08 | $691.83 | $1,819.70 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $416.87 Median $549.54 Typical High $912.01 | Professional | 26 · Professional part | $416.87 | $549.54 | $912.01 |
Geisinger Setting Professional Modifier TC · Technical part Typical Low $245.47 Median $281.84 Typical High $724.44 | Professional | TC · Technical part | $245.47 | $281.84 | $724.44 |
Martin's Point Setting Facility Modifier None Typical Low $602.56 Median $3,801.89 Typical High $8,709.64 | Facility | None | $602.56 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $478.63 Median $549.54 Typical High $602.56 | Professional | None (both parts) | $478.63 | $549.54 | $602.56 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $363.08 Median $416.87 Typical High $446.68 | Professional | 26 · Professional part | $363.08 | $416.87 | $446.68 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $138.04 Typical High $154.88 | Professional | TC · Technical part | $117.49 | $138.04 | $154.88 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $831.76 Median $831.76 Typical High $1,174.90 | Professional | None (both parts) | $831.76 | $831.76 | $1,174.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $616.60 Median $1,380.38 Typical High $2,398.83 | Facility | None | $616.60 | $1,380.38 | $2,398.83 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $616.60 Median $676.08 Typical High $794.33 | Professional | None (both parts) | $616.60 | $676.08 | $794.33 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 26 · Professional part | $380.19 | $398.11 | $398.11 |
UPMC Health Plan Setting Professional Modifier TC · Technical part Typical Low $218.78 Median $269.15 Typical High $288.40 | Professional | TC · Technical part | $218.78 | $269.15 | $288.40 |
United Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $1,698.24 | Facility | None | $70.79 | $141.25 | $1,698.24 |
United Setting Professional Modifier None (both parts) Typical Low $676.08 Median $954.99 Typical High $1,659.59 | Professional | None (both parts) | $676.08 | $954.99 | $1,659.59 |
United Setting Professional Modifier 26 · Professional part Typical Low $407.38 Median $537.03 Typical High $812.83 | Professional | 26 · Professional part | $407.38 | $537.03 | $812.83 |
United Setting Professional Modifier TC · Technical part Typical Low $275.42 Median $389.05 Typical High $676.08 | Professional | TC · Technical part | $275.42 | $389.05 | $676.08 |
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 $239.88 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $60.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $275.42 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $109.65 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $407.38 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $60.26 |
Where Pennsylvania sits
The same service costs 5.6 times more in Nebraska 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· 48th of 51
$617
NE $2,818MD $501
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.