How much rates vary
Facilitymedian $105 · 10th to 90th $66 to $550Professionalmedian $87 · 10th to 90th $62 to $151
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 $69.18 Median $100.00 Typical High $154.88 | Facility | None | $69.18 | $100.00 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $97.72 | Professional | None | $60.26 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $30.20 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $12.02 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $8.91 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.51 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.03 | $8.51 | $9.77 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $181.97 | Professional | None | $97.72 | $102.33 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $151.36 | Facility | None | $50.12 | $91.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $154.88 | Professional | None | $61.66 | $85.11 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | None | $138.04 | $181.97 | $181.97 |
Geisinger Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $154.88 | Facility | None | $70.79 | $89.13 | $154.88 |
Geisinger Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $194.98 | Professional | None | $79.43 | $112.20 | $194.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $177.83 Median $380.19 Typical High $912.01 | Facility | None | $177.83 | $380.19 | $912.01 |
Highmark BCBS Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $147.91 | Professional | None | $87.10 | $104.71 | $147.91 |
Martin's Point Setting Facility Modifier None Typical Low $69.18 Median $100.00 Typical High $162.18 | Facility | None | $69.18 | $100.00 | $162.18 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $97.72 | Professional | None | $60.26 | $85.11 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $30.20 | $41.69 | $48.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $12.02 | $16.98 | $19.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $8.91 | $12.59 | $14.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.51 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.03 | $8.51 | $9.77 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $181.97 | Professional | None | $93.33 | $93.33 | $181.97 |
UPMC Health Plan Setting Facility Modifier None Typical Low $56.23 Median $194.98 Typical High $457.09 | Facility | None | $56.23 | $194.98 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $93.33 | Professional | None | $56.23 | $75.86 | $93.33 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $128.82 | Professional | None | $66.07 | $87.10 | $128.82 |
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 $147.91 Median $151.36 Typical High $275.42 | Professional | 50 · Both sides | $147.91 | $151.36 | $275.42 |
Where Pennsylvania sits
The same service costs 3.7 times more in Alaska 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· 42nd of 51
$89.13
AK $275KY $74.13
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.