How much rates vary
Facilitymedian $46 · 10th to 90th $30 to $112Professionalmedian $62 · 10th to 90th $30 to $87
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 $29.51 Median $32.36 Typical High $83.18 | Facility | None | $29.51 | $32.36 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $66.07 Typical High $87.10 | Professional | None | $30.20 | $66.07 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $75.86 | Professional | None | $38.02 | $45.71 | $75.86 |
AmeriHealth Setting Professional Modifier None Typical Low $33.88 Median $38.90 Typical High $51.29 | Professional | None | $33.88 | $38.90 | $51.29 |
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 $51.29 Median $81.28 Typical High $81.28 | Professional | None | $51.29 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $46.77 Typical High $75.86 | Professional | None | $34.67 | $46.77 | $75.86 |
Emblem Health Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Emblem Health Setting Professional Modifier None Typical Low $30.20 Median $64.57 Typical High $93.33 | Professional | None | $30.20 | $64.57 | $93.33 |
Geisinger Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Facility | None | $34.67 | $34.67 | $41.69 |
Geisinger Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $77.62 | Professional | None | $36.31 | $54.95 | $77.62 |
Highmark BCBS Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $75.86 | Professional | None | $38.90 | $51.29 | $75.86 |
Independence Blue Cross Setting Professional Modifier None Typical Low $33.88 Median $38.90 Typical High $51.29 | Professional | None | $33.88 | $38.90 | $51.29 |
Martin's Point Setting Facility Modifier None Typical Low $29.51 Median $30.90 Typical High $83.18 | Facility | None | $29.51 | $30.90 | $83.18 |
Martin's Point Setting Professional Modifier None Typical Low $30.20 Median $66.07 Typical High $87.10 | Professional | None | $30.20 | $66.07 | $87.10 |
Optum Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $52.48 | Professional | None | $42.66 | $50.12 | $52.48 |
Oscar Health Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $83.18 | Professional | None | $38.02 | $47.86 | $83.18 |
UPMC Health Plan Setting Facility Modifier None Typical Low $45.71 Median $81.28 Typical High $120.23 | Facility | None | $45.71 | $81.28 | $120.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | None | $45.71 | $45.71 | $48.98 |
United Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $74.13 | Professional | None | $33.11 | $43.65 | $74.13 |
15 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 Facility Modifier 52 · Reduced service Typical Low $14.79 Median $15.14 Typical High $16.98 | Facility | 52 · Reduced service | $14.79 | $15.14 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $5.13 | Facility | 55 · Aftercare only | $4.47 | $4.57 | $5.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.39 | Facility | 56 · Pre-op care only | $2.95 | $3.02 | $3.39 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $1.70 Median $2.45 Typical High $87.10 | Facility | AF · Specialist physician | $1.70 | $2.45 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.14 Typical High $19.05 | Professional | 52 · Reduced service | $14.79 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $5.75 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.95 | $3.02 | $3.80 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $53.70 Median $66.07 Typical High $87.10 | Professional | GC · Resident with teaching physician | $53.70 | $66.07 | $87.10 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $14.79 Median $15.14 Typical High $16.98 | Facility | 52 · Reduced service | $14.79 | $15.14 | $16.98 |
Martin's Point Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $5.13 | Facility | 55 · Aftercare only | $4.47 | $4.57 | $5.13 |
Martin's Point Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.39 | Facility | 56 · Pre-op care only | $2.95 | $3.02 | $3.39 |
Martin's Point Setting Facility Modifier AF · Specialist physician Typical Low $1.70 Median $2.45 Typical High $87.10 | Facility | AF · Specialist physician | $1.70 | $2.45 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.14 Typical High $16.60 | Professional | 52 · Reduced service | $14.79 | $15.14 | $16.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $5.01 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $5.01 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.95 | $3.02 | $3.39 |
Where Pennsylvania sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 16th of 51
$61.66
AK $100NJ $37.15
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.