How much rates vary
Facilitymedian $100 · 10th to 90th $41 to $5,012Professionalmedian $65 · 10th to 90th $39 to $98
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 $40.74 Median $89.13 Typical High $1,412.54 | Facility | None | $40.74 | $89.13 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $97.72 | Professional | None | $38.90 | $64.57 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $32.36 Typical High $48.98 | Professional | 52 · Reduced service | $19.50 | $32.36 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.88 Typical High $19.50 | Professional | 53 · Discontinued | $7.76 | $12.88 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $9.77 Typical High $14.79 | Professional | 55 · Aftercare only | $5.75 | $9.77 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.46 Typical High $9.77 | Professional | 56 · Pre-op care only | $3.89 | $6.46 | $9.77 |
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 $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $89.13 | Professional | None | $30.20 | $72.44 | $89.13 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $158.49 | Professional | None | $114.82 | $114.82 | $158.49 |
Geisinger Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $158.49 | Professional | None | $51.29 | $93.33 | $158.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $537.03 Median $660.69 Typical High $741.31 | Facility | None | $537.03 | $660.69 | $741.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $120.23 | Professional | None | $52.48 | $52.48 | $120.23 |
Martin's Point Setting Facility Modifier None Typical Low $40.74 Median $97.72 Typical High $1,862.09 | Facility | None | $40.74 | $97.72 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $97.72 | Professional | None | $38.90 | $64.57 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $32.36 Typical High $48.98 | Professional | 52 · Reduced service | $19.50 | $32.36 | $48.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.88 Typical High $19.50 | Professional | 53 · Discontinued | $7.76 | $12.88 | $19.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $9.77 Typical High $14.79 | Professional | 55 · Aftercare only | $5.75 | $9.77 | $14.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.46 Typical High $9.77 | Professional | 56 · Pre-op care only | $3.89 | $6.46 | $9.77 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | None | $89.13 | $89.13 | $93.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $100.00 | Facility | None | $42.66 | $45.71 | $100.00 |
UPMC Health Plan Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $100.00 | Professional | None | $45.71 | $75.86 | $100.00 |
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 $37.15 Median $46.77 Typical High $102.33 | Professional | None | $37.15 | $46.77 | $102.33 |
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 2.5 times more in Alaska than in Washington, DC. 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· 37th of 51
$66.07
AK $129DC $51.29
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.