How much rates vary
Facilitymedian $126 · 10th to 90th $71 to $741Professionalmedian $115 · 10th to 90th $79 to $195
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 $89.13 Median $123.03 Typical High $208.93 | Facility | None | $89.13 | $123.03 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $125.89 | Professional | None | $77.62 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $38.90 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $15.49 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $11.75 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.76 | $10.72 | $12.59 |
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 $125.89 Median $131.83 Typical High $229.09 | Professional | None | $125.89 | $131.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $190.55 | Facility | None | $50.12 | $107.15 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $194.98 | Professional | None | $83.18 | $112.20 | $194.98 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $239.88 | Professional | None | $177.83 | $239.88 | $239.88 |
Geisinger Setting Facility Modifier None Typical Low $91.20 Median $112.20 Typical High $199.53 | Facility | None | $91.20 | $112.20 | $199.53 |
Geisinger Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $257.04 | Professional | None | $104.71 | $147.91 | $257.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $478.63 | Facility | None | $162.18 | $162.18 | $478.63 |
Martin's Point Setting Facility Modifier None Typical Low $89.13 Median $125.89 Typical High $208.93 | Facility | None | $89.13 | $125.89 | $208.93 |
Martin's Point Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $125.89 | Professional | None | $77.62 | $107.15 | $125.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $38.90 | $53.70 | $63.10 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $15.49 | $21.88 | $25.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $11.75 | $16.22 | $19.05 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.76 | $10.72 | $12.59 |
Oscar Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $234.42 | Professional | None | $120.23 | $120.23 | $234.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $79.43 Median $194.98 Typical High $457.09 | Facility | None | $79.43 | $194.98 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $120.23 | Professional | None | $79.43 | $95.50 | $120.23 |
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 $87.10 Median $114.82 Typical High $169.82 | Professional | None | $87.10 | $114.82 | $169.82 |
2 more rates 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 $190.55 Median $194.98 Typical High $346.74 | Professional | 50 · Both sides | $190.55 | $194.98 | $346.74 |
Highmark BCBS Setting Professional Modifier 58 · Staged procedure Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 58 · Staged procedure | $144.54 | $144.54 | $144.54 |
Where Pennsylvania sits
The same service costs 3.6 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· 41st of 51
$115
AK $355KY $97.72
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.