How much rates vary
Facilitymedian $479 · 10th to 90th $78 to $4,898Professionalmedian $195 · 10th to 90th $48 to $309
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 $234.42 Median $1,995.26 Typical High $7,943.28 | Facility | None | $234.42 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $165.96 Typical High $234.42 | Professional | None | $45.71 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $39.81 Typical High $117.49 | Professional | 52 · Reduced service | $22.91 | $39.81 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $15.85 Typical High $46.77 | Professional | 53 · Discontinued | $9.12 | $15.85 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $60.26 Typical High $177.83 | Professional | 54 · Surgery only | $34.67 | $60.26 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $12.02 Typical High $35.48 | Professional | 55 · Aftercare only | $6.92 | $12.02 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.94 Typical High $23.44 | Professional | 56 · Pre-op care only | $4.57 | $7.94 | $23.44 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $56,234.13 | Facility | None | $3,981.07 | $5,011.87 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $354.81 | Professional | None | $194.98 | $204.17 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,691.53 | Facility | None | $457.09 | $794.33 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $162.18 Typical High $269.15 | Professional | None | $48.98 | $162.18 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $354.81 | Professional | None | $263.03 | $354.81 | $354.81 |
Geisinger Setting Professional Modifier None Typical Low $48.98 Median $190.55 Typical High $346.74 | Professional | None | $48.98 | $190.55 | $346.74 |
Martin's Point Setting Facility Modifier None Typical Low $234.42 Median $1,819.70 Typical High $6,606.93 | Facility | None | $234.42 | $1,819.70 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $165.96 Typical High $234.42 | Professional | None | $45.71 | $165.96 | $234.42 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $39.81 Typical High $117.49 | Professional | 52 · Reduced service | $22.91 | $39.81 | $117.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $15.85 Typical High $46.77 | Professional | 53 · Discontinued | $9.12 | $15.85 | $46.77 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $60.26 Typical High $177.83 | Professional | 54 · Surgery only | $34.67 | $60.26 | $177.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $12.02 Typical High $35.48 | Professional | 55 · Aftercare only | $6.92 | $12.02 | $35.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.94 Typical High $23.44 | Professional | 56 · Pre-op care only | $4.57 | $7.94 | $23.44 |
Oscar Health Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $389.05 | Professional | None | $251.19 | $363.08 | $389.05 |
UPMC Health Plan Setting Facility Modifier None Typical Low $120.23 Median $295.12 Typical High $851.14 | Facility | None | $120.23 | $295.12 | $851.14 |
UPMC Health Plan Setting Professional Modifier None Typical Low $50.12 Median $208.93 Typical High $851.14 | Professional | None | $50.12 | $208.93 | $851.14 |
United Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $1,230.27 | Facility | None | $70.79 | $141.25 | $1,230.27 |
United Setting Professional Modifier None Typical Low $52.48 Median $138.04 Typical High $245.47 | Professional | None | $52.48 | $138.04 | $245.47 |
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 50 · Both sides Typical Low $295.12 Median $309.03 Typical High $524.81 | Professional | 50 · Both sides | $295.12 | $309.03 | $524.81 |
Where Pennsylvania sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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· 15th of 51
$195
IA $288KY $63.10
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.