How much rates vary
Facilitymedian $145 · 10th to 90th $107 to $288Professionalmedian $141 · 10th to 90th $107 to $229
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 $107.15 Median $138.04 Typical High $239.88 | Facility | None | $107.15 | $138.04 | $239.88 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $52.48 Median $63.10 Typical High $69.18 | Facility | 52 · Reduced service | $52.48 | $63.10 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $20.89 | Facility | 55 · Aftercare only | $15.85 | $19.05 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $13.80 | Facility | 56 · Pre-op care only | $10.47 | $12.59 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $181.97 | Professional | None | $104.71 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $60.26 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $15.85 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.02 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $12.02 | $13.18 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $269.15 | Professional | None | $144.54 | $181.97 | $269.15 |
AmeriHealth Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
AmeriHealth Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $190.55 | Professional | None | $141.25 | $154.88 | $190.55 |
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 Typical Low $234.42 Median $295.12 Typical High $323.59 | Professional | None | $234.42 | $295.12 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $257.04 | Facility | None | $109.65 | $147.91 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $194.98 | Professional | None | $107.15 | $138.04 | $194.98 |
Emblem Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Emblem Health Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $295.12 | Professional | None | $72.44 | $95.50 | $295.12 |
Geisinger Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $158.49 | Facility | None | $134.90 | $134.90 | $158.49 |
Geisinger Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $309.03 | Professional | None | $134.90 | $181.97 | $309.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $75.86 Median $162.18 Typical High $346.74 | Facility | None | $75.86 | $162.18 | $346.74 |
Highmark BCBS Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $275.42 | Professional | None | $138.04 | $186.21 | $275.42 |
Independence Blue Cross Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $2,570.40 | Facility | None | $177.83 | $177.83 | $2,570.40 |
Independence Blue Cross Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $190.55 | Professional | None | $141.25 | $158.49 | $190.55 |
Martin's Point Setting Facility Modifier None Typical Low $104.71 Median $138.04 Typical High $251.19 | Facility | None | $104.71 | $138.04 | $251.19 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $52.48 Median $63.10 Typical High $69.18 | Facility | 52 · Reduced service | $52.48 | $63.10 | $69.18 |
Martin's Point Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $20.89 | Facility | 55 · Aftercare only | $15.85 | $19.05 | $20.89 |
Martin's Point Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $13.80 | Facility | 56 · Pre-op care only | $10.47 | $12.59 | $13.80 |
Martin's Point Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $181.97 | Professional | None | $104.71 | $138.04 | $181.97 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $60.26 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $60.26 | $66.07 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $15.85 | $18.20 | $19.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.02 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $12.02 | $13.18 |
Optum Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $186.21 | Professional | None | $158.49 | $165.96 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $257.04 | Professional | None | $104.71 | $165.96 | $257.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $371.54 | Facility | None | $128.82 | $162.18 | $371.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $162.18 | Professional | None | $128.82 | $138.04 | $162.18 |
United Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $194.98 | Professional | None | $107.15 | $138.04 | $194.98 |
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 AF · Specialist physician Typical Low $123.03 Median $181.97 Typical High $316.23 | Professional | AF · Specialist physician | $123.03 | $181.97 | $316.23 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $91.20 Median $138.04 Typical High $239.88 | Professional | HO · Master's level | $91.20 | $138.04 | $239.88 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $102.33 Median $154.88 Typical High $269.15 | Professional | TD · Registered nurse | $102.33 | $154.88 | $269.15 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $144.54 Median $173.78 Typical High $275.42 | Professional | 25 · Same-day visit | $144.54 | $173.78 | $275.42 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $165.96 Median $269.15 Typical High $269.15 | Professional | 57 · Decision for surgery | $165.96 | $269.15 | $269.15 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $186.21 Median $239.88 Typical High $338.84 | Professional | GC · Resident with teaching physician | $186.21 | $239.88 | $338.84 |
Ambetter Setting Professional Modifier U6 · State-defined Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | U6 · State-defined | $173.78 | $173.78 | $173.78 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $138.04 Median $177.83 Typical High $263.03 | Professional | 25 · Same-day visit | $138.04 | $177.83 | $263.03 |
Highmark BCBS Setting Professional Modifier FS · Shared visit Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | FS · Shared visit | $123.03 | $144.54 | $162.18 |
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $134.90 Median $194.98 Typical High $229.09 | Professional | GC · Resident with teaching physician | $134.90 | $194.98 | $229.09 |
Martin's Point Setting Professional Modifier AF · Specialist physician Typical Low $123.03 Median $181.97 Typical High $316.23 | Professional | AF · Specialist physician | $123.03 | $181.97 | $316.23 |
Martin's Point Setting Professional Modifier HO · Master's level Typical Low $91.20 Median $138.04 Typical High $239.88 | Professional | HO · Master's level | $91.20 | $138.04 | $239.88 |
Martin's Point Setting Professional Modifier TD · Registered nurse Typical Low $102.33 Median $154.88 Typical High $269.15 | Professional | TD · Registered nurse | $102.33 | $154.88 | $269.15 |
Where Pennsylvania sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 34th of 51
$141
AK $263AL $115
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.