How much rates vary
Facilitymedian $214 · 10th to 90th $50 to $4,266Professionalmedian $23 · 10th to 90th $19 to $55
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 $21.38 Median $3,630.78 Typical High $8,511.38 | Facility | None | $21.38 | $3,630.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $21.38 Typical High $50.12 | Professional | None | $18.62 | $21.38 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $10.72 Typical High $11.75 | Professional | 52 · Reduced service | $9.33 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.27 Typical High $4.79 | Professional | 53 · Discontinued | $3.72 | $4.27 | $4.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $15.85 Typical High $17.78 | Professional | 54 · Surgery only | $14.13 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.16 Typical High $3.55 | Professional | 55 · Aftercare only | $2.82 | $3.16 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.14 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.86 | $2.14 | $2.34 |
Ambetter Setting Professional Modifier None Typical Low $16.98 Median $21.38 Typical High $21.38 | Professional | None | $16.98 | $21.38 | $21.38 |
AmeriHealth Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
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 $18.62 Median $19.50 Typical High $37.15 | Professional | None | $18.62 | $19.50 | $37.15 |
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 $16.60 Median $42.66 Typical High $54.95 | Professional | None | $16.60 | $42.66 | $54.95 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $30.90 | Professional | None | $22.39 | $22.39 | $30.90 |
Geisinger Setting Professional Modifier None Typical Low $19.95 Median $48.98 Typical High $83.18 | Professional | None | $19.95 | $48.98 | $83.18 |
Highmark BCBS Setting Facility Modifier None Typical Low $83.18 Median $575.44 Typical High $676.08 | Facility | None | $83.18 | $575.44 | $676.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $29.51 | Professional | None | $21.38 | $22.91 | $29.51 |
Independence Blue Cross Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Martin's Point Setting Facility Modifier None Typical Low $23.44 Median $3,630.78 Typical High $8,709.64 | Facility | None | $23.44 | $3,630.78 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $18.62 Median $21.38 Typical High $48.98 | Professional | None | $18.62 | $21.38 | $48.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $10.72 Typical High $11.75 | Professional | 52 · Reduced service | $9.33 | $10.72 | $11.75 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.27 Typical High $4.68 | Professional | 53 · Discontinued | $3.72 | $4.27 | $4.68 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $15.85 Typical High $17.78 | Professional | 54 · Surgery only | $14.13 | $15.85 | $17.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.16 Typical High $3.55 | Professional | 55 · Aftercare only | $2.82 | $3.16 | $3.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.14 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.86 | $2.14 | $2.34 |
Oscar Health Setting Professional Modifier None Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | None | $95.50 | $97.72 | $97.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $21.38 Median $416.87 Typical High $912.01 | Facility | None | $21.38 | $416.87 | $912.01 |
UPMC Health Plan Setting Professional Modifier None Typical Low $18.62 Median $72.44 Typical High $104.71 | Professional | None | $18.62 | $72.44 | $104.71 |
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 $24.55 Median $30.20 Typical High $56.23 | Professional | None | $24.55 | $30.20 | $56.23 |
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 $28.18 Median $28.84 Typical High $56.23 | Professional | 50 · Both sides | $28.18 | $28.84 | $56.23 |
Where Pennsylvania sits
The same service costs 4.3 times more in Wyoming 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· 50th of 51
$23.44
WY $89.13NY $20.89
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.