How much rates vary
Facilitymedian $66 · 10th to 90th $55 to $251Professionalmedian $76 · 10th to 90th $56 to $132
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 $54.95 Median $58.88 Typical High $83.18 | Facility | None | $54.95 | $58.88 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $109.65 | Professional | None | $54.95 | $74.13 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $117.49 | Professional | None | $61.66 | $72.44 | $117.49 |
AmeriHealth Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $87.10 | Professional | None | $63.10 | $74.13 | $87.10 |
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 $117.49 Median $131.83 Typical High $134.90 | Professional | None | $117.49 | $131.83 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $128.82 | Professional | None | $61.66 | $74.13 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $41.69 Median $104.71 Typical High $147.91 | Professional | None | $41.69 | $104.71 | $147.91 |
Geisinger Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Facility | None | $61.66 | $61.66 | $74.13 |
Geisinger Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $138.04 | Professional | None | $61.66 | $89.13 | $138.04 |
Highmark BCBS Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $117.49 | Professional | None | $72.44 | $85.11 | $117.49 |
Independence Blue Cross Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $93.33 | Professional | None | $63.10 | $74.13 | $93.33 |
Martin's Point Setting Facility Modifier None Typical Low $54.95 Median $57.54 Typical High $83.18 | Facility | None | $54.95 | $57.54 | $83.18 |
Martin's Point Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $109.65 | Professional | None | $56.23 | $74.13 | $109.65 |
Optum Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $83.18 | Professional | None | $56.23 | $79.43 | $83.18 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $134.90 | Professional | None | $60.26 | $79.43 | $134.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $75.86 Median $186.21 Typical High $269.15 | Facility | None | $75.86 | $186.21 | $269.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | None | $75.86 | $75.86 | $77.62 |
United Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $134.90 | Professional | None | $60.26 | $75.86 | $134.90 |
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 $27.54 Median $28.18 Typical High $30.90 | Facility | 52 · Reduced service | $27.54 | $28.18 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $9.33 | Facility | 55 · Aftercare only | $8.13 | $8.32 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $6.17 | Facility | 56 · Pre-op care only | $5.50 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $28.18 Typical High $33.11 | Professional | 52 · Reduced service | $27.54 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $10.00 | Professional | 55 · Aftercare only | $8.13 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $6.61 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $69.18 Median $104.71 Typical High $134.90 | Professional | GC · Resident with teaching physician | $69.18 | $104.71 | $134.90 |
Highmark BCBS Setting Professional Modifier FS · Shared visit Typical Low $74.13 Median $83.18 Typical High $91.20 | Professional | FS · Shared visit | $74.13 | $83.18 | $91.20 |
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $81.28 Median $93.33 Typical High $125.89 | Professional | GC · Resident with teaching physician | $81.28 | $93.33 | $125.89 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $27.54 Median $28.18 Typical High $30.90 | Facility | 52 · Reduced service | $27.54 | $28.18 | $30.90 |
Martin's Point Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $9.33 | Facility | 55 · Aftercare only | $8.13 | $8.32 | $9.33 |
Martin's Point Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $6.17 | Facility | 56 · Pre-op care only | $5.50 | $5.62 | $6.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $27.54 | $28.18 | $29.51 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $8.91 | Professional | 55 · Aftercare only | $8.13 | $8.32 | $8.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $5.89 |
Where Pennsylvania sits
The same service costs 2.4 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· 35th of 51
$75.86
AK $155AL $64.57
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.