How much rates vary
Facilitymedian $1,778 · 10th to 90th $347 to $9,550Professionalmedian $105 · 10th to 90th $87 to $178
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 $97.72 Median $138.04 Typical High $181.97 | Facility | None | $97.72 | $138.04 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $138.04 | Professional | None | $83.18 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $48.98 Typical High $52.48 | Professional | 52 · Reduced service | $41.69 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.50 Typical High $20.89 | Professional | 53 · Discontinued | $16.98 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $15.85 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $10.47 |
AmeriHealth Setting Facility Modifier None Typical Low $4,168.69 Median $10,471.29 Typical High $15,848.93 | Facility | None | $4,168.69 | $10,471.29 | $15,848.93 |
AmeriHealth Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | None | $107.15 | $107.15 | $125.89 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | None | $162.18 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $1,621.81 Typical High $2,818.38 | Facility | None | $354.81 | $1,621.81 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $213.80 | Professional | None | $97.72 | $138.04 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | None | $147.91 | $147.91 | $169.82 |
Geisinger Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,715.35 | Facility | None | $1,698.24 | $2,089.30 | $3,715.35 |
Geisinger Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $223.87 | Professional | None | $95.50 | $128.82 | $223.87 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $6,918.31 Typical High $13,182.57 | Facility | None | $1,380.38 | $6,918.31 | $13,182.57 |
Independence Blue Cross Setting Facility Modifier None Typical Low $4,168.69 Median $7,244.36 Typical High $15,848.93 | Facility | None | $4,168.69 | $7,244.36 | $15,848.93 |
Independence Blue Cross Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | None | $107.15 | $107.15 | $125.89 |
Martin's Point Setting Facility Modifier None Typical Low $97.72 Median $141.25 Typical High $309.03 | Facility | None | $97.72 | $141.25 | $309.03 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $141.25 | Professional | None | $83.18 | $97.72 | $141.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $48.98 Typical High $50.12 | Professional | 52 · Reduced service | $41.69 | $48.98 | $50.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $16.98 | $19.50 | $20.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $15.14 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $15.14 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $10.00 |
Oscar Health Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $213.80 | Professional | None | $117.49 | $151.36 | $213.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $100.00 Median $691.83 Typical High $1,380.38 | Facility | None | $100.00 | $691.83 | $1,380.38 |
UPMC Health Plan Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $141.25 | Professional | None | $100.00 | $141.25 | $141.25 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,466.84 | Facility | None | $812.83 | $1,318.26 | $4,466.84 |
United Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $208.93 | Professional | None | $97.72 | $114.82 | $208.93 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | GC · Resident with teaching physician | $72.44 | $72.44 | $72.44 |
Where Pennsylvania sits
The same service costs 7.9 times more in Kansas than in New York. 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· 35th of 51
$138
KS $832NY $105
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.