How much rates vary
Facilitymedian $170 · 10th to 90th $55 to $3,981Professionalmedian $81 · 10th to 90th $49 to $151
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 $53.70 Median $1,584.89 Typical High $8,511.38 | Facility | None | $53.70 | $1,584.89 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $134.90 | Professional | None | $44.67 | $67.61 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $33.88 Typical High $41.69 | Professional | 52 · Reduced service | $22.39 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $13.49 Typical High $16.60 | Professional | 53 · Discontinued | $8.91 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $50.12 Typical High $61.66 | Professional | 54 · Surgery only | $33.88 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.00 Typical High $12.30 | Professional | 55 · Aftercare only | $6.76 | $10.00 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.47 | $6.76 | $8.32 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $8,709.64 | Facility | None | $1,202.26 | $1,258.93 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $213.80 | Professional | None | $77.62 | $128.82 | $213.80 |
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 $51.29 Median $85.11 Typical High $154.88 | Professional | None | $51.29 | $85.11 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | None | $128.82 | $128.82 | $134.90 |
Geisinger Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $165.96 | Professional | None | $63.10 | $112.20 | $165.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $457.09 Median $524.81 Typical High $1,023.29 | Facility | None | $457.09 | $524.81 | $1,023.29 |
Martin's Point Setting Facility Modifier None Typical Low $53.70 Median $1,584.89 Typical High $8,511.38 | Facility | None | $53.70 | $1,584.89 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $138.04 | Professional | None | $44.67 | $67.61 | $138.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $33.88 Typical High $41.69 | Professional | 52 · Reduced service | $22.39 | $33.88 | $41.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $13.49 Typical High $16.60 | Professional | 53 · Discontinued | $8.91 | $13.49 | $16.60 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $50.12 Typical High $61.66 | Professional | 54 · Surgery only | $33.88 | $50.12 | $61.66 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.00 Typical High $12.30 | Professional | 55 · Aftercare only | $6.76 | $10.00 | $12.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.47 | $6.76 | $8.32 |
Oscar Health Setting Professional Modifier None Typical Low $5.01 Median $95.50 Typical High $275.42 | Professional | None | $5.01 | $95.50 | $275.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $295.12 | Facility | None | $75.86 | $134.90 | $295.12 |
UPMC Health Plan Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $131.83 | Professional | None | $50.12 | $85.11 | $131.83 |
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 $48.98 Median $79.43 Typical High $147.91 | Professional | None | $48.98 | $79.43 | $147.91 |
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 $190.55 Typical High $316.23 | Professional | 50 · Both sides | $117.49 | $190.55 | $316.23 |
Where Pennsylvania sits
The same service costs 3.2 times more in Wisconsin 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· 44th of 51
$83.18
WI $229KY $72.44
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.