How much rates vary
Facilitymedian $191 · 10th to 90th $81 to $501Professionalmedian $89 · 10th to 90th $51 to $126
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 $93.33 Median $245.47 Typical High $501.19 | Facility | None | $93.33 | $245.47 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $144.54 | Professional | None | $67.61 | $93.33 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $114.82 | Professional | None | $57.54 | $70.79 | $114.82 |
AmeriHealth Setting Facility Modifier None Typical Low $42.66 Median $107.15 Typical High $10,471.29 | Facility | None | $42.66 | $107.15 | $10,471.29 |
AmeriHealth Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Capital Blue Cross Setting Facility Modifier None Typical Low $316.23 Median $407.38 Typical High $5,011.87 | Facility | None | $316.23 | $407.38 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | None | $89.13 | $89.13 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $154.88 Typical High $331.13 | Facility | None | $75.86 | $154.88 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Emblem Health Setting Professional Modifier None Typical Low $15.14 Median $53.70 Typical High $165.96 | Professional | None | $15.14 | $53.70 | $165.96 |
Geisinger Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Geisinger Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $204.17 | Professional | None | $60.26 | $79.43 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $83.18 Median $239.88 Typical High $524.81 | Facility | None | $83.18 | $239.88 | $524.81 |
Highmark BCBS Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $95.50 | Professional | None | $69.18 | $77.62 | $95.50 |
Independence Blue Cross Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $208.93 | Facility | None | $66.07 | $100.00 | $208.93 |
Independence Blue Cross Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Martin's Point Setting Facility Modifier None Typical Low $97.72 Median $263.03 Typical High $602.56 | Facility | None | $97.72 | $263.03 | $602.56 |
Martin's Point Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $109.65 | Professional | None | $67.61 | $93.33 | $109.65 |
UPMC Health Plan Setting Facility Modifier None Typical Low $87.10 Median $218.78 Typical High $331.13 | Facility | None | $87.10 | $218.78 | $331.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $114.82 | Professional | None | $87.10 | $100.00 | $114.82 |
United Setting Facility Modifier None Typical Low $102.33 Median $114.82 Typical High $138.04 | Facility | None | $102.33 | $114.82 | $138.04 |
United Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $162.18 | Professional | None | $40.74 | $69.18 | $162.18 |
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 $42.66 Median $46.77 Typical High $48.98 | Professional | 52 · Reduced service | $42.66 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $19.50 | Professional | 53 · Discontinued | $16.98 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $69.18 Typical High $72.44 | Professional | 54 · Surgery only | $63.10 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $9.77 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 52 · Reduced service | $46.77 | $46.77 | $48.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 53 · Discontinued | $18.62 | $18.62 | $19.50 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 54 · Surgery only | $69.18 | $69.18 | $72.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $9.77 |
Where Pennsylvania sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 20th of 51
$102
AK $224GA $45.71
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.