How much rates vary
Facilitymedian $66 · 10th to 90th $19 to $550Professionalmedian $32 · 10th to 90th $17 to $55
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 $17.38 Median $19.05 Typical High $33.88 | Facility | None | $17.38 | $19.05 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $29.51 Typical High $33.88 | Professional | None | $16.98 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $14.79 Typical High $16.98 | Professional | 52 · Reduced service | $8.51 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.89 Typical High $6.92 | Professional | 53 · Discontinued | $3.39 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.47 Typical High $5.13 | Professional | 55 · Aftercare only | $2.51 | $4.47 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.95 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.70 | $2.95 | $3.39 |
AmeriHealth Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 $50.12 Median $57.54 Typical High $72.44 | Professional | None | $50.12 | $57.54 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $29.51 Typical High $100.00 | Facility | None | $18.62 | $29.51 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $33.88 Typical High $61.66 | Professional | None | $17.78 | $33.88 | $61.66 |
Emblem Health Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $52.48 | Professional | None | $40.74 | $52.48 | $52.48 |
Geisinger Setting Facility Modifier None Typical Low $17.78 Median $22.39 Typical High $38.90 | Facility | None | $17.78 | $22.39 | $38.90 |
Geisinger Setting Professional Modifier None Typical Low $31.62 Median $48.98 Typical High $95.50 | Professional | None | $31.62 | $48.98 | $95.50 |
Independence Blue Cross Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $120.23 | Professional | None | $34.67 | $34.67 | $120.23 |
Martin's Point Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $33.88 | Facility | None | $19.05 | $19.05 | $33.88 |
Martin's Point Setting Professional Modifier None Typical Low $16.98 Median $29.51 Typical High $33.88 | Professional | None | $16.98 | $29.51 | $33.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $14.79 Typical High $16.98 | Professional | 52 · Reduced service | $8.51 | $14.79 | $16.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.89 Typical High $6.92 | Professional | 53 · Discontinued | $3.39 | $5.89 | $6.92 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.47 Typical High $5.13 | Professional | 55 · Aftercare only | $2.51 | $4.47 | $5.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.95 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.70 | $2.95 | $3.39 |
Oscar Health Setting Professional Modifier None Typical Low $3.02 Median $79.43 Typical High $102.33 | Professional | None | $3.02 | $79.43 | $102.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $18.20 Median $54.95 Typical High $104.71 | Facility | None | $18.20 | $54.95 | $104.71 |
UPMC Health Plan Setting Professional Modifier None Typical Low $18.20 Median $38.02 Typical High $54.95 | Professional | None | $18.20 | $38.02 | $54.95 |
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 $19.05 Median $33.88 Typical High $52.48 | Professional | None | $19.05 | $33.88 | $52.48 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 59 · Distinct service | $30.20 | $30.20 | $30.20 |
Where Pennsylvania sits
The same service costs 3.5 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· 44th of 51
$31.62
AK $83.18VA $23.99
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.