How much rates vary
Facilitymedian $65 · 10th to 90th $26 to $550Professionalmedian $43 · 10th to 90th $27 to $68
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 $26.30 Median $28.18 Typical High $43.65 | Facility | None | $26.30 | $28.18 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $37.15 Typical High $43.65 | Professional | None | $25.12 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $18.62 Typical High $21.38 | Professional | 52 · Reduced service | $12.59 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $7.41 Typical High $8.71 | Professional | 53 · Discontinued | $5.01 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $5.62 Typical High $6.46 | Professional | 55 · Aftercare only | $3.80 | $5.62 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.72 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.51 | $3.72 | $4.37 |
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 $43.65 Median $44.67 Typical High $83.18 | Professional | None | $43.65 | $44.67 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $38.90 Typical High $100.00 | Facility | None | $23.99 | $38.90 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $70.79 | Professional | None | $27.54 | $41.69 | $70.79 |
Emblem Health Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | None | $57.54 | $74.13 | $74.13 |
Geisinger Setting Facility Modifier None Typical Low $22.91 Median $28.84 Typical High $51.29 | Facility | None | $22.91 | $28.84 | $51.29 |
Geisinger Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $93.33 | Professional | None | $41.69 | $56.23 | $93.33 |
Martin's Point Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $43.65 | Facility | None | $28.18 | $28.18 | $43.65 |
Martin's Point Setting Professional Modifier None Typical Low $25.12 Median $37.15 Typical High $43.65 | Professional | None | $25.12 | $37.15 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $18.62 Typical High $21.38 | Professional | 52 · Reduced service | $12.59 | $18.62 | $21.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $7.41 Typical High $8.71 | Professional | 53 · Discontinued | $5.01 | $7.41 | $8.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $5.62 Typical High $6.46 | Professional | 55 · Aftercare only | $3.80 | $5.62 | $6.46 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.72 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.51 | $3.72 | $4.37 |
Oscar Health Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $102.33 | Professional | None | $51.29 | $61.66 | $102.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $26.92 Median $48.98 Typical High $72.44 | Facility | None | $26.92 | $48.98 | $72.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $26.92 Median $41.69 Typical High $48.98 | Professional | None | $26.92 | $41.69 | $48.98 |
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 $29.51 Median $42.66 Typical High $60.26 | Professional | None | $29.51 | $42.66 | $60.26 |
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 $64.57 Median $67.61 Typical High $123.03 | Professional | 50 · Both sides | $64.57 | $67.61 | $123.03 |
Where Pennsylvania sits
The same service costs 3.3 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· 41st of 51
$42.66
AK $112VA $33.88
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.