How much rates vary
Facilitymedian $912 · 10th to 90th $89 to $5,012Professionalmedian $89 · 10th to 90th $81 to $182
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $81.28 Median $89.13 Typical High $1,862.09 | Facility | None | $81.28 | $89.13 | $1,862.09 |
Aetna Setting Professional Modifier None (both parts) Typical Low $77.62 Median $83.18 Typical High $89.13 | Professional | None (both parts) | $77.62 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $38.90 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $15.49 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $11.48 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.91 |
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 $83.18 Median $117.49 Typical High $186.21 | Professional | None (both parts) | $83.18 | $117.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,202.26 Typical High $1,445.44 | Facility | None | $588.84 | $1,202.26 | $1,445.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $97.72 Typical High $426.58 | Professional | None (both parts) | $70.79 | $97.72 | $426.58 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $100.00 Median $112.20 Typical High $128.82 | Professional | None (both parts) | $100.00 | $112.20 | $128.82 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $69.18 Median $87.10 Typical High $190.55 | Professional | None (both parts) | $69.18 | $87.10 | $190.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $891.25 | Facility | None | $758.58 | $758.58 | $891.25 |
Martin's Point Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $1,862.09 | Facility | None | $89.13 | $89.13 | $1,862.09 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $79.43 Median $83.18 Typical High $89.13 | Professional | None (both parts) | $79.43 | $83.18 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $38.90 | $41.69 | $44.67 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $15.49 | $16.60 | $17.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $11.48 | $12.30 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.91 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $93.33 Median $109.65 Typical High $181.97 | Professional | None (both parts) | $93.33 | $109.65 | $181.97 |
UPMC Health Plan Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $91.20 | Facility | None | $81.28 | $91.20 | $91.20 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | None (both parts) | $81.28 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,096.48 Typical High $1,258.93 | Facility | None | $512.86 | $1,096.48 | $1,258.93 |
United Setting Professional Modifier None (both parts) Typical Low $72.44 Median $95.50 Typical High $177.83 | Professional | None (both parts) | $72.44 | $95.50 | $177.83 |
3 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 TC · Technical part Typical Low $81.28 Median $93.33 Typical High $107.15 | Professional | TC · Technical part | $81.28 | $93.33 | $107.15 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $83.18 Median $95.50 Typical High $154.88 | Professional | TC · Technical part | $83.18 | $95.50 | $154.88 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $77.62 Median $93.33 Typical High $102.33 | Professional | TC · Technical part | $77.62 | $93.33 | $102.33 |
Where Pennsylvania sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 38th of 51
$89.13
AK $219FL $75.86
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.