How much rates vary
Facilitymedian $302 · 10th to 90th $55 to $3,020Professionalmedian $79 · 10th to 90th $43 to $148
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 $83.18 Median $2,344.23 Typical High $8,317.64 | Facility | None | $83.18 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $87.10 | Professional | None | $38.90 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $35.48 Typical High $41.69 | Professional | 52 · Reduced service | $19.05 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $14.13 Typical High $16.98 | Professional | 53 · Discontinued | $7.76 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $28.84 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $5.75 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $7.08 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.89 | $7.08 | $8.32 |
AmeriHealth Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | None | $79.43 | $79.43 | $81.28 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $199.53 | Professional | None | $79.43 | $81.28 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $245.47 Typical High $549.54 | Facility | None | $56.23 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $81.28 Typical High $151.36 | Professional | None | $43.65 | $81.28 | $151.36 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $138.04 | Professional | None | $102.33 | $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 $79.43 Median $112.20 Typical High $223.87 | Professional | None | $79.43 | $112.20 | $223.87 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Independence Blue Cross Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | None | $79.43 | $79.43 | $81.28 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $83.18 | Professional | None | $38.90 | $70.79 | $83.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $35.48 Typical High $41.69 | Professional | 52 · Reduced service | $19.05 | $35.48 | $41.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $14.13 Typical High $16.98 | Professional | 53 · Discontinued | $7.76 | $14.13 | $16.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $28.84 | $52.48 | $63.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $5.75 | $10.47 | $12.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $7.08 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.89 | $7.08 | $8.32 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $239.88 | Professional | None | $123.03 | $177.83 | $239.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $79.43 Median $363.08 Typical High $831.76 | Facility | None | $79.43 | $363.08 | $831.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $43.65 Median $107.15 Typical High $158.49 | Professional | None | $43.65 | $107.15 | $158.49 |
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 $44.67 Median $79.43 Typical High $138.04 | Professional | None | $44.67 | $79.43 | $138.04 |
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 $117.49 Median $123.03 Typical High $295.12 | Professional | 50 · Both sides | $117.49 | $123.03 | $295.12 |
Where Pennsylvania sits
The same service costs 3.0 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· 44th of 51
$81.28
AK $182VA $60.26
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.