How much rates vary
Facilitymedian $2,138 · 10th to 90th $708 to $5,012Professionalmedian $891 · 10th to 90th $224 to $1,514
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 $954.99 Median $1,148.15 Typical High $2,089.30 | Facility | None | $954.99 | $1,148.15 | $2,089.30 |
Aetna Setting Professional Modifier None (both parts) Typical Low $954.99 Median $977.24 Typical High $1,148.15 | Professional | None (both parts) | $954.99 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | 26 · Professional part | $190.55 | $204.17 | $223.87 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $758.58 Median $794.33 Typical High $912.01 | Professional | TC · Technical part | $758.58 | $794.33 | $912.01 |
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 (both parts) Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | None (both parts) | $223.87 | $223.87 | $234.42 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $199.53 Median $295.12 Typical High $416.87 | Professional | 26 · Professional part | $199.53 | $295.12 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $2,238.72 | Facility | None | $1,047.13 | $1,862.09 | $2,238.72 |
Cigna Setting Professional Modifier None (both parts) Typical Low $912.01 Median $1,096.48 Typical High $5,128.61 | Professional | None (both parts) | $912.01 | $1,096.48 | $5,128.61 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $229.09 Typical High $1,023.29 | Professional | 26 · Professional part | $190.55 | $229.09 | $1,023.29 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $724.44 Median $912.01 Typical High $4,073.80 | Professional | TC · Technical part | $724.44 | $912.01 | $4,073.80 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $446.68 Median $3,019.95 Typical High $4,677.35 | Professional | None (both parts) | $446.68 | $3,019.95 | $4,677.35 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $234.42 Typical High $467.74 | Professional | 26 · Professional part | $204.17 | $234.42 | $467.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $6,309.57 Typical High $6,456.54 | Facility | None | $2,511.89 | $6,309.57 | $6,456.54 |
Highmark BCBS Setting Professional Modifier 26 · Professional part Typical Low $1,348.96 Median $1,380.38 Typical High $1,412.54 | Professional | 26 · Professional part | $1,348.96 | $1,380.38 | $1,412.54 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,089.30 | Facility | None | $1,148.15 | $1,148.15 | $2,089.30 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $954.99 Median $977.24 Typical High $1,148.15 | Professional | None (both parts) | $954.99 | $977.24 | $1,148.15 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | 26 · Professional part | $190.55 | $204.17 | $223.87 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $758.58 Median $776.25 Typical High $912.01 | Professional | TC · Technical part | $758.58 | $776.25 | $912.01 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $2,290.87 Typical High $2,290.87 | Professional | None (both parts) | $1,148.15 | $2,290.87 | $2,290.87 |
UPMC Health Plan Setting Facility Modifier None Typical Low $676.08 Median $2,187.76 Typical High $3,467.37 | Facility | None | $676.08 | $2,187.76 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | None (both parts) | $676.08 | $707.95 | $707.95 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 26 · Professional part | $204.17 | $208.93 | $208.93 |
UPMC Health Plan Setting Professional Modifier TC · Technical part Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | TC · Technical part | $478.63 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $2,511.89 Typical High $2,884.03 | Facility | None | $1,174.90 | $2,511.89 | $2,884.03 |
United Setting Professional Modifier None (both parts) Typical Low $660.69 Median $1,659.59 Typical High $3,090.30 | Professional | None (both parts) | $660.69 | $1,659.59 | $3,090.30 |
United Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $213.80 Typical High $407.38 | Professional | 26 · Professional part | $181.97 | $213.80 | $407.38 |
United Setting Professional Modifier TC · Technical part Typical Low $416.87 Median $1,479.11 Typical High $2,754.23 | Professional | TC · Technical part | $416.87 | $1,479.11 | $2,754.23 |
8 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 $478.63 Median $489.78 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $489.78 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $489.78 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $194.98 | $229.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $114.82 |
Where Pennsylvania sits
The same service costs 11.2 times more in Alaska 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· 44th of 51
$912
AK $3,020KY $269
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.