How much rates vary
Facilitymedian $155 · 10th to 90th $78 to $3,020Professionalmedian $129 · 10th to 90th $93 to $219
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 $138.04 Median $1,995.26 Typical High $7,943.28 | Facility | None | $138.04 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $141.25 | Professional | None | $89.13 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $17.78 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $13.18 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.91 | $12.02 | $13.80 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $144.54 | Professional | None | $89.13 | $89.13 | $144.54 |
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 $138.04 Median $141.25 Typical High $257.04 | Professional | None | $138.04 | $141.25 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $194.98 | Facility | None | $50.12 | $107.15 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $218.78 | Professional | None | $95.50 | $125.89 | $218.78 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $257.04 | Professional | None | $190.55 | $257.04 | $257.04 |
Geisinger Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $204.17 | Facility | None | $93.33 | $114.82 | $204.17 |
Geisinger Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $281.84 | Professional | None | $117.49 | $165.96 | $281.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $158.49 Median $478.63 Typical High $851.14 | Facility | None | $158.49 | $478.63 | $851.14 |
Highmark BCBS Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $177.83 | Professional | None | $141.25 | $162.18 | $177.83 |
Martin's Point Setting Facility Modifier None Typical Low $138.04 Median $1,819.70 Typical High $6,606.93 | Facility | None | $138.04 | $1,819.70 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $138.04 | Professional | None | $89.13 | $120.23 | $138.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $60.26 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $17.78 | $23.99 | $28.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $13.18 | $17.78 | $20.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.91 | $12.02 | $13.80 |
Oscar Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $263.03 | Professional | None | $138.04 | $138.04 | $263.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $93.33 Median $199.53 Typical High $457.09 | Facility | None | $93.33 | $199.53 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $131.83 | Professional | None | $93.33 | $109.65 | $131.83 |
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 $100.00 Median $128.82 Typical High $186.21 | Professional | None | $100.00 | $128.82 | $186.21 |
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 $204.17 Median $213.80 Typical High $380.19 | Professional | 50 · Both sides | $204.17 | $213.80 | $380.19 |
Where Pennsylvania sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 41st of 51
$129
AK $398FL $107
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.