How much rates vary
Facilitymedian $132 · 10th to 90th $50 to $1,202Professionalmedian $34 · 10th to 90th $18 to $56
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 $18.62 Typical High $36.31 | Facility | None | $17.38 | $18.62 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $36.31 | Professional | None | $16.60 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $15.85 Typical High $18.20 | Professional | 52 · Reduced service | $8.32 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $6.31 Typical High $7.24 | Professional | 53 · Discontinued | $3.31 | $6.31 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.68 Typical High $5.50 | Professional | 55 · Aftercare only | $2.51 | $4.68 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $3.16 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.66 | $3.16 | $3.63 |
AmeriHealth Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
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 $33.88 Median $34.67 Typical High $60.26 | Professional | None | $33.88 | $34.67 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $35.48 Typical High $61.66 | Professional | None | $17.78 | $35.48 | $61.66 |
Emblem Health Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $57.54 | Professional | None | $45.71 | $57.54 | $57.54 |
Geisinger Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $97.72 | Professional | None | $34.67 | $50.12 | $97.72 |
Independence Blue Cross Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $100.00 | Professional | None | $37.15 | $37.15 | $100.00 |
Martin's Point Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $36.31 | Facility | None | $18.62 | $18.62 | $36.31 |
Martin's Point Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $36.31 | Professional | None | $16.60 | $31.62 | $36.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $15.85 Typical High $18.20 | Professional | 52 · Reduced service | $8.32 | $15.85 | $18.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $6.31 Typical High $7.24 | Professional | 53 · Discontinued | $3.31 | $6.31 | $7.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.68 Typical High $5.50 | Professional | 55 · Aftercare only | $2.51 | $4.68 | $5.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $3.16 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.66 | $3.16 | $3.63 |
Oscar Health Setting Professional Modifier None Typical Low $3.98 Median $81.28 Typical High $97.72 | Professional | None | $3.98 | $81.28 | $97.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $33.88 Median $194.98 Typical High $436.52 | Facility | None | $33.88 | $194.98 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $17.78 Median $35.48 Typical High $52.48 | Professional | None | $17.78 | $35.48 | $52.48 |
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 $19.50 Median $36.31 Typical High $53.70 | Professional | None | $19.50 | $36.31 | $53.70 |
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 $50.12 Median $52.48 Typical High $91.20 | Professional | 50 · Both sides | $50.12 | $52.48 | $91.20 |
Where Pennsylvania sits
The same service costs 3.8 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
$34.67
AK $91.20VA $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.