How much rates vary
Facilitymedian $123 · 10th to 90th $59 to $479Professionalmedian $83 · 10th to 90th $50 to $123
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 $67.61 Median $112.20 Typical High $1,412.54 | Facility | None | $67.61 | $112.20 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $123.03 | Professional | None | $67.61 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $39.81 Typical High $61.66 | Professional | 52 · Reduced service | $33.88 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.02 Typical High $18.20 | Professional | 55 · Aftercare only | $10.23 | $12.02 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $12.30 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $131.83 | Professional | None | $112.20 | $120.23 | $131.83 |
AmeriHealth Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
AmeriHealth Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $117.49 | Professional | None | $70.79 | $117.49 | $117.49 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $100.00 Median $288.40 Typical High $295.12 | Professional | None | $100.00 | $288.40 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $72.44 Typical High $114.82 | Professional | None | $50.12 | $72.44 | $114.82 |
Emblem Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Geisinger Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $204.17 | Professional | None | $85.11 | $123.03 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $97.72 Median $120.23 Typical High $489.78 | Facility | None | $97.72 | $120.23 | $489.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $165.96 | Professional | None | $102.33 | $112.20 | $165.96 |
Independence Blue Cross Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $398.11 | Facility | None | $131.83 | $181.97 | $398.11 |
Independence Blue Cross Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $117.49 | Professional | None | $70.79 | $117.49 | $117.49 |
Martin's Point Setting Facility Modifier None Typical Low $72.44 Median $123.03 Typical High $223.87 | Facility | None | $72.44 | $123.03 | $223.87 |
Martin's Point Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $123.03 | Professional | None | $67.61 | $89.13 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $38.90 Typical High $61.66 | Professional | 52 · Reduced service | $33.88 | $38.90 | $61.66 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $18.20 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $18.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.76 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.76 | $7.76 | $12.30 |
Oscar Health Setting Facility Modifier None Typical Low $147.91 Median $208.93 Typical High $281.84 | Facility | None | $147.91 | $208.93 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $87.10 | Professional | None | $44.67 | $44.67 | $87.10 |
UPMC Health Plan Setting Facility Modifier None Typical Low $52.48 Median $72.44 Typical High $123.03 | Facility | None | $52.48 | $72.44 | $123.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $123.03 | Professional | None | $58.88 | $89.13 | $123.03 |
United Setting Facility Modifier None Typical Low $181.97 Median $389.05 Typical High $446.68 | Facility | None | $181.97 | $389.05 | $446.68 |
United Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $131.83 | Professional | None | $46.77 | $81.28 | $131.83 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 25 · Same-day visit | $102.33 | $112.20 | $114.82 |
Where Pennsylvania sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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· 39th of 51
$85.11
AK $263NC $61.66
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.