How much rates vary
Facilitymedian $52 · 10th to 90th $41 to $132Professionalmedian $45 · 10th to 90th $41 to $56
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 $40.74 Median $42.66 Typical High $102.33 | Facility | None | $40.74 | $42.66 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $51.29 | Professional | None | $40.74 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
AmeriHealth Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $60.26 | Facility | None | $52.48 | $52.48 | $60.26 |
AmeriHealth Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Capital Blue Cross Setting Facility Modifier None Typical Low $42.66 Median $47.86 Typical High $57.54 | Facility | None | $42.66 | $47.86 | $57.54 |
Capital Blue Cross Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $194.98 | Facility | None | $51.29 | $85.11 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Geisinger Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Geisinger Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | None | $61.66 | $61.66 | $72.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $46.77 Median $102.33 Typical High $173.78 | Facility | None | $46.77 | $102.33 | $173.78 |
Independence Blue Cross Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $60.26 | Facility | None | $52.48 | $52.48 | $60.26 |
Independence Blue Cross Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Martin's Point Setting Facility Modifier None Typical Low $40.74 Median $42.66 Typical High $102.33 | Facility | None | $40.74 | $42.66 | $102.33 |
Martin's Point Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $63.10 | Professional | None | $40.74 | $40.74 | $63.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $20.42 | $20.42 | $20.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
UPMC Health Plan Setting Facility Modifier None Typical Low $27.54 Median $46.77 Typical High $51.29 | Facility | None | $27.54 | $46.77 | $51.29 |
UPMC Health Plan Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $32.36 | Professional | None | $27.54 | $27.54 | $32.36 |
United Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $66.07 | Professional | None | $45.71 | $52.48 | $66.07 |
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 AT · Acute treatment Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | AT · Acute treatment | $33.88 | $33.88 | $33.88 |
Where Pennsylvania sits
The same service costs 6.0 times more in Arizona than in Rhode Island. 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· 25th of 51
$47.86
AZ $57.54RI $9.55
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.