How much rates vary
Facilitymedian $1,514 · 10th to 90th $776 to $4,266Professionalmedian $1,122 · 10th to 90th $35 to $1,862
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 $912.01 Median $1,047.13 Typical High $1,230.27 | Facility | None | $912.01 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,230.27 | Professional | None | $812.83 | $933.25 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,584.89 | $1,584.89 |
AmeriHealth Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $2,818.38 | Facility | None | $794.33 | $1,862.09 | $2,818.38 |
AmeriHealth Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,288.25 | $1,318.26 |
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 $1,148.15 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,621.81 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,621.81 | $2,041.74 | $2,818.38 |
Geisinger Setting Professional Modifier None Typical Low $38.02 Median $1,258.93 Typical High $2,344.23 | Professional | None | $38.02 | $1,258.93 | $2,344.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,235.94 | Facility | None | $1,905.46 | $1,905.46 | $3,235.94 |
Highmark BCBS Setting Professional Modifier None Typical Low $37.15 Median $1,202.26 Typical High $1,318.26 | Professional | None | $37.15 | $1,202.26 | $1,318.26 |
Independence Blue Cross Setting Facility Modifier None Typical Low $812.83 Median $1,659.59 Typical High $2,818.38 | Facility | None | $812.83 | $1,659.59 | $2,818.38 |
Independence Blue Cross Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,288.25 | $1,412.54 |
Martin's Point Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,230.27 | Facility | None | $933.25 | $1,047.13 | $1,230.27 |
Martin's Point Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,230.27 | Professional | None | $812.83 | $933.25 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $1,230.27 Typical High $2,630.27 | Professional | None | $34.67 | $1,230.27 | $2,630.27 |
UPMC Health Plan Setting Facility Modifier None Typical Low $27.54 Median $1,096.48 Typical High $1,148.15 | Facility | None | $27.54 | $1,096.48 | $1,148.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $27.54 Median $1,096.48 Typical High $1,148.15 | Professional | None | $27.54 | $1,096.48 | $1,148.15 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $4,677.35 Typical High $5,495.41 | Facility | None | $2,238.72 | $4,677.35 | $5,495.41 |
United Setting Professional Modifier None Typical Low $21.88 Median $794.33 Typical High $1,202.26 | Professional | None | $21.88 | $794.33 | $1,202.26 |
8 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 $537.03 Median $537.03 Typical High $616.60 | Professional | 52 · Reduced service | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 52 · Reduced service | $537.03 | $537.03 | $616.60 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $213.80 | $245.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $186.21 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $123.03 |
Where Pennsylvania sits
The same service costs 49.0 times more in Hawaii than in Maryland. 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· 7th of 51
$1,122
HI $1,622MD $33.11
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.