How much rates vary
Facilitymedian $100 · 10th to 90th $30 to $5,012Professionalmedian $74 · 10th to 90th $28 to $100
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 $29.51 Median $89.13 Typical High $1,412.54 | Facility | None | $29.51 | $89.13 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $61.66 Typical High $100.00 | Professional | None | $28.18 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $30.90 Typical High $50.12 | Professional | 52 · Reduced service | $14.13 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $12.30 Typical High $19.95 | Professional | 53 · Discontinued | $5.62 | $12.30 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $9.33 Typical High $15.14 | Professional | 55 · Aftercare only | $4.27 | $9.33 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $6.17 Typical High $10.00 | Professional | 56 · Pre-op care only | $2.82 | $6.17 | $10.00 |
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 $97.72 Median $100.00 Typical High $100.00 | Professional | None | $97.72 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $66.07 Typical High $91.20 | Professional | None | $21.88 | $66.07 | $91.20 |
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 $74.13 Median $97.72 Typical High $128.82 | Professional | None | $74.13 | $97.72 | $128.82 |
Martin's Point Setting Facility Modifier None Typical Low $29.51 Median $100.00 Typical High $1,862.09 | Facility | None | $29.51 | $100.00 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $28.18 Median $61.66 Typical High $100.00 | Professional | None | $28.18 | $61.66 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $30.90 Typical High $50.12 | Professional | 52 · Reduced service | $14.13 | $30.90 | $50.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $12.30 Typical High $19.95 | Professional | 53 · Discontinued | $5.62 | $12.30 | $19.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $9.33 Typical High $15.14 | Professional | 55 · Aftercare only | $4.27 | $9.33 | $15.14 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $6.17 Typical High $10.00 | Professional | 56 · Pre-op care only | $2.82 | $6.17 | $10.00 |
Oscar Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | None | $70.79 | $70.79 | $75.86 |
UPMC Health Plan Setting Facility Modifier None Typical Low $30.90 Median $35.48 Typical High $97.72 | Facility | None | $30.90 | $35.48 | $97.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $30.90 Median $70.79 Typical High $97.72 | Professional | None | $30.90 | $70.79 | $97.72 |
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 $30.20 Median $39.81 Typical High $102.33 | Professional | None | $30.20 | $39.81 | $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 3.5 times more in Hawaii 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· 18th of 51
$74.13
HI $135MD $38.02
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.