How much rates vary
Facilitymedian $105 · 10th to 90th $44 to $151Professionalmedian $132 · 10th to 90th $100 to $263
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 $100.00 Median $104.71 Typical High $147.91 | Facility | None | $100.00 | $104.71 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $162.18 | Professional | None | $100.00 | $117.49 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $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 $100.00 Median $251.19 Typical High $323.59 | Professional | None | $100.00 | $251.19 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $208.93 | Professional | None | $91.20 | $131.83 | $208.93 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $208.93 | Professional | None | $102.33 | $144.54 | $208.93 |
Geisinger Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Facility | None | $120.23 | $120.23 | $144.54 |
Geisinger Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $257.04 | Professional | None | $100.00 | $141.25 | $257.04 |
Highmark BCBS Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $147.91 | Professional | None | $93.33 | $100.00 | $147.91 |
Independence Blue Cross Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Martin's Point Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $144.54 | Facility | None | $100.00 | $102.33 | $144.54 |
Martin's Point Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $162.18 | Professional | None | $100.00 | $117.49 | $162.18 |
Optum Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $147.91 | Professional | None | $100.00 | $104.71 | $147.91 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $257.04 | Professional | None | $100.00 | $114.82 | $257.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $33.11 Median $46.77 Typical High $151.36 | Facility | None | $33.11 | $46.77 | $151.36 |
UPMC Health Plan Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $151.36 | Professional | None | $97.72 | $151.36 | $151.36 |
United Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $251.19 | Professional | None | $102.33 | $134.90 | $251.19 |
12 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 $50.12 Median $51.29 Typical High $57.54 | Facility | 52 · Reduced service | $50.12 | $51.29 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $16.98 | Facility | 55 · Aftercare only | $15.14 | $15.14 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $11.48 | Facility | 56 · Pre-op care only | $10.00 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $50.12 Typical High $51.29 | Professional | 52 · Reduced service | $48.98 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.14 Typical High $15.49 | Professional | 55 · Aftercare only | $14.79 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $10.23 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $50.12 Median $51.29 Typical High $57.54 | Facility | 52 · Reduced service | $50.12 | $51.29 | $57.54 |
Martin's Point Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $16.98 | Facility | 55 · Aftercare only | $15.14 | $15.14 | $16.98 |
Martin's Point Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $11.48 | Facility | 56 · Pre-op care only | $10.00 | $10.23 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $50.12 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $10.23 |
Where Pennsylvania sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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· 25th of 51
$132
AK $209DC $102
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.