How much rates vary
Facilitymedian $29 · 10th to 90th $21 to $4,266Professionalmedian $24 · 10th to 90th $14 to $29
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 $28.84 Median $28.84 Typical High $38.02 | Facility | None | $28.84 | $28.84 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
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 $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $19.50 Typical High $27.54 | Professional | None | $19.05 | $19.50 | $27.54 |
Emblem Health Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Geisinger Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $23.44 | Facility | None | $21.38 | $21.38 | $23.44 |
Geisinger Setting Professional Modifier None Typical Low $17.38 Median $22.91 Typical High $26.92 | Professional | None | $17.38 | $22.91 | $26.92 |
Martin's Point Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $38.02 | Facility | None | $28.84 | $28.84 | $38.02 |
Martin's Point Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Optum Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | None | $23.99 | $23.99 | $26.30 |
Oscar Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | None | $23.99 | $23.99 | $26.30 |
United Setting Facility Modifier None Typical Low $51.29 Median $109.65 Typical High $125.89 | Facility | None | $51.29 | $109.65 | $125.89 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | None | $23.99 | $23.99 | $26.30 |
1 more rate 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 HO · Master's level Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | HO · Master's level | $14.13 | $14.13 | $14.13 |
Where Pennsylvania sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 37th of 51
$23.99
NY $64.57NC $5.50
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.