How much rates vary
Facilitymedian $178 · 10th to 90th $58 to $1,096Professionalmedian $79 · 10th to 90th $41 to $132
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 $42.66 Median $114.82 Typical High $501.19 | Facility | None | $42.66 | $114.82 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $72.44 Typical High $91.20 | Professional | None | $37.15 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $36.31 Typical High $41.69 | Professional | 52 · Reduced service | $18.62 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $7.41 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.72 Typical High $12.59 | Professional | 55 · Aftercare only | $5.62 | $10.72 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $7.24 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.72 | $7.24 | $8.32 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
AmeriHealth Setting Facility Modifier None Typical Low $645.65 Median $1,621.81 Typical High $2,454.71 | Facility | None | $645.65 | $1,621.81 | $2,454.71 |
AmeriHealth Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $69.18 | Professional | None | $43.65 | $46.77 | $69.18 |
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 $83.18 Median $87.10 Typical High $165.96 | Professional | None | $83.18 | $87.10 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $134.90 | Facility | None | $50.12 | $81.28 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $134.90 | Professional | None | $40.74 | $79.43 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | None | $125.89 | $169.82 | $169.82 |
Geisinger Setting Facility Modifier None Typical Low $64.57 Median $79.43 Typical High $141.25 | Facility | None | $64.57 | $79.43 | $141.25 |
Geisinger Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $177.83 | Professional | None | $70.79 | $107.15 | $177.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $645.65 | Facility | None | $257.04 | $416.87 | $645.65 |
Highmark BCBS Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $114.82 | Professional | None | $83.18 | $95.50 | $114.82 |
Independence Blue Cross Setting Facility Modifier None Typical Low $218.78 Median $1,122.02 Typical High $2,454.71 | Facility | None | $218.78 | $1,122.02 | $2,454.71 |
Independence Blue Cross Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $69.18 | Professional | None | $43.65 | $46.77 | $69.18 |
Martin's Point Setting Facility Modifier None Typical Low $42.66 Median $141.25 Typical High $630.96 | Facility | None | $42.66 | $141.25 | $630.96 |
Martin's Point Setting Professional Modifier None Typical Low $37.15 Median $72.44 Typical High $85.11 | Professional | None | $37.15 | $72.44 | $85.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $18.62 | $34.67 | $41.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $14.13 Typical High $16.98 | Professional | 53 · Discontinued | $7.41 | $14.13 | $16.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $5.62 | $10.47 | $12.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $7.08 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.72 | $7.08 | $8.32 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $165.96 | Professional | None | $93.33 | $93.33 | $165.96 |
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 $41.69 Median $81.28 Typical High $81.28 | Professional | None | $41.69 | $81.28 | $81.28 |
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 $42.66 Median $77.62 Typical High $107.15 | Professional | None | $42.66 | $77.62 | $107.15 |
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 $125.89 Median $128.82 Typical High $245.47 | Professional | 50 · Both sides | $125.89 | $128.82 | $245.47 |
Where Pennsylvania sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 38th of 51
$79.43
AK $214VA $56.23
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.