How much rates vary
Facilitymedian $398 · 10th to 90th $214 to $3,090Professionalmedian $316 · 10th to 90th $186 to $417
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 $186.21 Median $186.21 Typical High $199.53 | Facility | None | $186.21 | $186.21 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $204.17 | Professional | None | $181.97 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $91.20 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.90 Typical High $40.74 | Professional | 53 · Discontinued | $37.15 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $27.54 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.50 Typical High $20.42 | Professional | 56 · Pre-op care only | $18.20 | $19.50 | $20.42 |
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 $346.74 Median $416.87 Typical High $416.87 | Professional | None | $346.74 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $2,137.96 | Professional | None | $316.23 | $316.23 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $724.44 | Professional | None | $398.11 | $616.60 | $724.44 |
Geisinger Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Geisinger Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $426.58 | Professional | None | $223.87 | $257.04 | $426.58 |
Martin's Point Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $199.53 | Facility | None | $186.21 | $186.21 | $199.53 |
Martin's Point Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $204.17 | Professional | None | $186.21 | $199.53 | $204.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $100.00 Typical High $102.33 | Professional | 52 · Reduced service | $93.33 | $100.00 | $102.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $39.81 Typical High $40.74 | Professional | 53 · Discontinued | $37.15 | $39.81 | $40.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $28.18 | $29.51 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.95 Typical High $20.42 | Professional | 56 · Pre-op care only | $18.62 | $19.95 | $20.42 |
Oscar Health Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $630.96 | Professional | None | $257.04 | $436.52 | $630.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $288.40 Median $1,621.81 Typical High $3,090.30 | Facility | None | $288.40 | $1,621.81 | $3,090.30 |
UPMC Health Plan Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $346.74 | Professional | None | $190.55 | $213.80 | $346.74 |
2 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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 50 · Both sides | $380.19 | $416.87 | $416.87 |
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | PN · Off-campus dept, non-excepted | $2,754.23 | $2,754.23 | $2,754.23 |
Where Pennsylvania sits
The same service costs 3.4 times more in Montana than in New York. 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· 27th of 51
$316
MT $589NY $174
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.