How much rates vary
Facilitymedian $282 · 10th to 90th $20 to $724Professionalmedian $25 · 10th to 90th $18 to $29
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 $19.05 Median $24.55 Typical High $1,412.54 | Facility | None | $19.05 | $24.55 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $23.44 Typical High $26.92 | Professional | None | $17.78 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $11.48 Typical High $13.49 | Professional | 52 · Reduced service | $8.91 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.57 Typical High $5.37 | Professional | 53 · Discontinued | $3.63 | $4.57 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.47 Typical High $4.07 | Professional | 55 · Aftercare only | $2.69 | $3.47 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.29 Typical High $2.69 | Professional | 56 · Pre-op care only | $1.78 | $2.29 | $2.69 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | None | $25.70 | $25.70 | $32.36 |
AmeriHealth Setting Facility Modifier None Typical Low $165.96 Median $416.87 Typical High $630.96 | Facility | None | $165.96 | $416.87 | $630.96 |
AmeriHealth Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
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 $26.92 Median $27.54 Typical High $30.90 | Professional | None | $26.92 | $27.54 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $20.42 Typical High $27.54 | Professional | None | $13.49 | $20.42 | $27.54 |
Emblem Health Setting Professional Modifier None Typical Low $8.13 Median $23.99 Typical High $32.36 | Professional | None | $8.13 | $23.99 | $32.36 |
Geisinger Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $47.86 | Professional | None | $21.88 | $29.51 | $47.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $39.81 Median $190.55 Typical High $602.56 | Facility | None | $39.81 | $190.55 | $602.56 |
Highmark BCBS Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $37.15 | Professional | None | $30.20 | $32.36 | $37.15 |
Independence Blue Cross Setting Facility Modifier None Typical Low $151.36 Median $288.40 Typical High $630.96 | Facility | None | $151.36 | $288.40 | $630.96 |
Independence Blue Cross Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Martin's Point Setting Facility Modifier None Typical Low $19.05 Median $26.92 Typical High $1,862.09 | Facility | None | $19.05 | $26.92 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $17.78 Median $22.91 Typical High $26.92 | Professional | None | $17.78 | $22.91 | $26.92 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $11.48 Typical High $13.49 | Professional | 52 · Reduced service | $8.91 | $11.48 | $13.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.57 Typical High $5.37 | Professional | 53 · Discontinued | $3.63 | $4.57 | $5.37 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.39 Typical High $4.07 | Professional | 55 · Aftercare only | $2.69 | $3.39 | $4.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.29 Typical High $2.69 | Professional | 56 · Pre-op care only | $1.78 | $2.29 | $2.69 |
Oscar Health Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | None | $36.31 | $36.31 | $38.02 |
UPMC Health Plan Setting Facility Modifier None Typical Low $19.95 Median $26.92 Typical High $46.77 | Facility | None | $19.95 | $26.92 | $46.77 |
UPMC Health Plan Setting Professional Modifier None Typical Low $19.95 Median $26.92 Typical High $46.77 | Professional | None | $19.95 | $26.92 | $46.77 |
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 $17.78 Median $21.88 Typical High $28.84 | Professional | None | $17.78 | $21.88 | $28.84 |
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 59 · Distinct service Typical Low $30.90 Median $32.36 Typical High $33.11 | Professional | 59 · Distinct service | $30.90 | $32.36 | $33.11 |
Where Pennsylvania sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 28th of 51
$24.55
AK $72.44NJ $18.20
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.