How much rates vary
Facilitymedian $115 · 10th to 90th $50 to $1,202Professionalmedian $48 · 10th to 90th $31 to $83
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 $35.48 Median $35.48 Typical High $54.95 | Facility | None | $35.48 | $35.48 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $54.95 | Professional | None | $30.90 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $22.39 Typical High $26.92 | Professional | 52 · Reduced service | $15.49 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $9.12 Typical High $10.96 | Professional | 53 · Discontinued | $6.17 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $6.76 Typical High $8.13 | Professional | 55 · Aftercare only | $4.57 | $6.76 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.47 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.09 | $4.47 | $5.50 |
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 $54.95 Median $57.54 Typical High $97.72 | Professional | None | $54.95 | $57.54 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $85.11 | Professional | None | $28.84 | $44.67 | $85.11 |
Emblem Health Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $102.33 | Professional | None | $75.86 | $102.33 | $102.33 |
Geisinger Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $107.15 | Professional | None | $40.74 | $64.57 | $107.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Professional | None | $50.12 | $50.12 | $64.57 |
Martin's Point Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $54.95 | Facility | None | $35.48 | $35.48 | $54.95 |
Martin's Point Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $54.95 | Professional | None | $30.90 | $46.77 | $54.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $22.39 Typical High $26.92 | Professional | 52 · Reduced service | $15.49 | $22.39 | $26.92 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $8.91 Typical High $10.96 | Professional | 53 · Discontinued | $6.17 | $8.91 | $10.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $4.57 | $6.61 | $8.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.47 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.09 | $4.47 | $5.50 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $97.72 | Professional | None | $64.57 | $93.33 | $97.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $30.90 Median $141.25 Typical High $309.03 | Facility | None | $30.90 | $141.25 | $309.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $52.48 | Professional | None | $30.90 | $45.71 | $52.48 |
United Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $1,230.27 | Facility | None | $75.86 | $151.36 | $1,230.27 |
United Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $70.79 | Professional | None | $32.36 | $46.77 | $70.79 |
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 $83.18 Median $85.11 Typical High $144.54 | Professional | 50 · Both sides | $83.18 | $85.11 | $144.54 |
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· 38th of 51
$51.29
AK $148KY $39.81
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.