How much rates vary
Facilitymedian $87 · 10th to 90th $52 to $741Professionalmedian $76 · 10th to 90th $52 to $120
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 $54.95 Median $77.62 Typical High $141.25 | Facility | None | $54.95 | $77.62 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $89.13 | Professional | None | $47.86 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $33.11 Typical High $38.90 | Professional | 52 · Reduced service | $23.99 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.18 Typical High $15.49 | Professional | 53 · Discontinued | $9.55 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.00 Typical High $11.48 | Professional | 55 · Aftercare only | $7.24 | $10.00 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.61 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.79 | $6.61 | $7.76 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
AmeriHealth Setting Professional Modifier None Typical Low $38.90 Median $79.43 Typical High $85.11 | Professional | None | $38.90 | $79.43 | $85.11 |
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 $75.86 Median $79.43 Typical High $147.91 | Professional | None | $75.86 | $79.43 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $67.61 Typical High $112.20 | Facility | None | $50.12 | $67.61 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $128.82 | Professional | None | $52.48 | $72.44 | $128.82 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $138.04 | Professional | None | $104.71 | $138.04 | $138.04 |
Geisinger Setting Facility Modifier None Typical Low $50.12 Median $63.10 Typical High $109.65 | Facility | None | $50.12 | $63.10 | $109.65 |
Geisinger Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $169.82 | Professional | None | $67.61 | $89.13 | $169.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $707.95 | Facility | None | $131.83 | $131.83 | $707.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $616.60 | Professional | None | $74.13 | $89.13 | $616.60 |
Independence Blue Cross Setting Professional Modifier None Typical Low $38.90 Median $79.43 Typical High $91.20 | Professional | None | $38.90 | $79.43 | $91.20 |
Martin's Point Setting Facility Modifier None Typical Low $54.95 Median $77.62 Typical High $141.25 | Facility | None | $54.95 | $77.62 | $141.25 |
Martin's Point Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $85.11 | Professional | None | $47.86 | $66.07 | $85.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $33.11 Typical High $38.90 | Professional | 52 · Reduced service | $23.99 | $33.11 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.18 Typical High $15.49 | Professional | 53 · Discontinued | $9.55 | $13.18 | $15.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.00 Typical High $11.48 | Professional | 55 · Aftercare only | $7.24 | $10.00 | $11.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.61 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.79 | $6.61 | $7.76 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $186.21 | Professional | None | $89.13 | $100.00 | $186.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $70.79 Median $190.55 Typical High $436.52 | Facility | None | $70.79 | $190.55 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $91.20 | Professional | None | $52.48 | $72.44 | $91.20 |
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 $56.23 Median $75.86 Typical High $112.20 | Professional | None | $56.23 | $75.86 | $112.20 |
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 $114.82 Median $120.23 Typical High $218.78 | Professional | 50 · Both sides | $114.82 | $120.23 | $218.78 |
Where Pennsylvania sits
The same service costs 3.5 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· 42nd of 51
$75.86
AK $219FL $63.10
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.