How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,884 to $38,019Professionalmedian $676 · 10th to 90th $135 to $776
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 $707.95 Median $8,709.64 Typical High $33,884.42 | Facility | None | $707.95 | $8,709.64 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $2,238.72 | Professional | None | $676.08 | $676.08 | $2,238.72 |
AmeriHealth Setting Facility Modifier None Typical Low $6,165.95 Median $14,791.08 Typical High $45,708.82 | Facility | None | $6,165.95 | $14,791.08 | $45,708.82 |
Capital Blue Cross Setting Facility Modifier None Typical Low $25,118.86 Median $47,863.01 Typical High $47,863.01 | Facility | None | $25,118.86 | $47,863.01 | $47,863.01 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $10,000.00 Typical High $15,488.17 | Facility | None | $7,244.36 | $10,000.00 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Geisinger Setting Facility Modifier None Typical Low $7,244.36 Median $9,120.11 Typical High $15,848.93 | Facility | None | $7,244.36 | $9,120.11 | $15,848.93 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $27,542.29 Typical High $50,118.72 | Facility | None | $10,964.78 | $27,542.29 | $50,118.72 |
Independence Blue Cross Setting Facility Modifier None Typical Low $5,888.44 Median $15,135.61 Typical High $79,432.82 | Facility | None | $5,888.44 | $15,135.61 | $79,432.82 |
Martin's Point Setting Facility Modifier None Typical Low $707.95 Median $9,120.11 Typical High $35,481.34 | Facility | None | $707.95 | $9,120.11 | $35,481.34 |
Martin's Point Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $933.25 | Professional | None | $676.08 | $676.08 | $933.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $5,495.41 Median $7,585.78 Typical High $12,302.69 | Facility | None | $5,495.41 | $7,585.78 | $12,302.69 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $5,754.40 Typical High $25,703.96 | Facility | None | $2,818.38 | $5,754.40 | $25,703.96 |
10 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 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $77.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Where Pennsylvania sits
The same service costs 281.8 times more in Minnesota than in Montana. 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· 32nd of 51
$7,244
MN $22,387MT $79.43
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.