How much rates vary
Facilitymedian $100 · 10th to 90th $60 to $724Professionalmedian $74 · 10th to 90th $15 to $123
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 $15.85 Median $75.86 Typical High $912.01 | Facility | None | $15.85 | $75.86 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $25.12 Typical High $87.10 | Professional | None | $14.13 | $25.12 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $12.59 Typical High $43.65 | Professional | 52 · Reduced service | $7.08 | $12.59 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $5.01 Typical High $17.38 | Professional | 53 · Discontinued | $2.82 | $5.01 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $8.71 Typical High $13.18 | Professional | 55 · Aftercare only | $2.14 | $8.71 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.51 Typical High $8.71 | Professional | 56 · Pre-op care only | $1.45 | $2.51 | $8.71 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $77.62 Typical High $141.25 | Professional | None | $75.86 | $77.62 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $660.69 | Facility | None | $58.88 | $97.72 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $69.18 Typical High $109.65 | Professional | None | $15.14 | $69.18 | $109.65 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $125.89 | Professional | None | $95.50 | $125.89 | $125.89 |
Geisinger Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $134.90 | Facility | None | $61.66 | $77.62 | $134.90 |
Geisinger Setting Professional Modifier None Typical Low $14.79 Median $70.79 Typical High $123.03 | Professional | None | $14.79 | $70.79 | $123.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $281.84 Median $380.19 Typical High $741.31 | Facility | None | $281.84 | $380.19 | $741.31 |
Martin's Point Setting Facility Modifier None Typical Low $15.85 Median $87.10 Typical High $954.99 | Facility | None | $15.85 | $87.10 | $954.99 |
Martin's Point Setting Professional Modifier None Typical Low $14.13 Median $25.12 Typical High $87.10 | Professional | None | $14.13 | $25.12 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $12.59 Typical High $43.65 | Professional | 52 · Reduced service | $7.08 | $12.59 | $43.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $5.01 Typical High $17.38 | Professional | 53 · Discontinued | $2.82 | $5.01 | $17.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $8.71 Typical High $13.18 | Professional | 55 · Aftercare only | $2.14 | $8.71 | $13.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.51 Typical High $8.71 | Professional | 56 · Pre-op care only | $1.45 | $2.51 | $8.71 |
Oscar Health Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $467.74 | Professional | None | $91.20 | $144.54 | $467.74 |
UPMC Health Plan Setting Facility Modifier None Typical Low $14.13 Median $15.49 Typical High $77.62 | Facility | None | $14.13 | $15.49 | $77.62 |
UPMC Health Plan Setting Professional Modifier None Typical Low $14.13 Median $60.26 Typical High $77.62 | Professional | None | $14.13 | $60.26 | $77.62 |
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 $16.60 Median $57.54 Typical High $100.00 | Professional | None | $16.60 | $57.54 | $100.00 |
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 $112.20 Median $117.49 Typical High $213.80 | Professional | 50 · Both sides | $112.20 | $117.49 | $213.80 |
Where Pennsylvania sits
The same service costs 5.9 times more in Iowa 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· 22nd of 51
$74.13
IA $117KY $19.95
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.