How much rates vary
Facilitymedian $105 · 10th to 90th $50 to $5,012Professionalmedian $83 · 10th to 90th $47 to $105
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $50.12 Median $93.33 Typical High $1,412.54 | Facility | None | $50.12 | $93.33 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $104.71 | Professional | None | $46.77 | $67.61 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $33.11 Typical High $51.29 | Professional | 52 · Reduced service | $23.44 | $33.11 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.18 Typical High $20.89 | Professional | 53 · Discontinued | $9.33 | $13.18 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.00 Typical High $15.49 | Professional | 55 · Aftercare only | $7.08 | $10.00 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.61 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.68 | $6.61 | $10.47 |
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 $102.33 Typical High $102.33 | Professional | None | $100.00 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $74.13 Typical High $93.33 | Professional | None | $35.48 | $74.13 | $93.33 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Geisinger Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $158.49 | Professional | None | $58.88 | $93.33 | $158.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,290.87 | Facility | None | $1,862.09 | $1,862.09 | $2,290.87 |
Martin's Point Setting Facility Modifier None Typical Low $50.12 Median $104.71 Typical High $1,862.09 | Facility | None | $50.12 | $104.71 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $104.71 | Professional | None | $46.77 | $67.61 | $104.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $33.11 Typical High $51.29 | Professional | 52 · Reduced service | $23.44 | $33.11 | $51.29 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.18 Typical High $20.89 | Professional | 53 · Discontinued | $9.33 | $13.18 | $20.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.00 Typical High $15.49 | Professional | 55 · Aftercare only | $7.08 | $10.00 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.61 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.68 | $6.61 | $10.47 |
Oscar Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | None | $95.50 | $95.50 | $100.00 |
UPMC Health Plan Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $104.71 | Facility | None | $51.29 | $51.29 | $104.71 |
UPMC Health Plan Setting Professional Modifier None Typical Low $51.29 Median $81.28 Typical High $104.71 | Professional | None | $51.29 | $81.28 | $104.71 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,318.26 Typical High $1,513.56 | Facility | None | $616.60 | $1,318.26 | $1,513.56 |
United Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $109.65 | Professional | None | $39.81 | $56.23 | $109.65 |
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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Pennsylvania sits
The same service costs 2.8 times more in Alaska than in Maryland. 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· 20th of 51
$83.18
AK $155MD $54.95
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.