How much rates vary
Facilitymedian $46 · 10th to 90th $5 to $182Professionalmedian $5 · 10th to 90th $4 to $6
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 $4.27 Median $5.25 Typical High $1,862.09 | Facility | None | $4.27 | $5.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $5.25 | Professional | None | $4.27 | $4.37 | $5.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $2.19 Typical High $2.63 | Professional | 52 · Reduced service | $2.14 | $2.19 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.87 Typical High $1.05 | Professional | 53 · Discontinued | $0.85 | $0.87 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.66 Typical High $0.78 | Professional | 55 · Aftercare only | $0.65 | $0.66 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.44 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.43 | $0.44 | $0.52 |
Ambetter Setting Professional Modifier None Typical Low $3.98 Median $4.68 Typical High $7.59 | Professional | None | $3.98 | $4.68 | $7.59 |
AmeriHealth Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.13 | Professional | None | $4.37 | $4.37 | $5.13 |
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 $4.47 Median $4.57 Typical High $7.24 | Professional | None | $4.47 | $4.57 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $6.03 | Professional | None | $3.02 | $3.98 | $6.03 |
Emblem Health Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.62 | Professional | None | $4.27 | $4.27 | $5.62 |
Geisinger Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.62 | Facility | None | $5.13 | $5.13 | $5.62 |
Geisinger Setting Professional Modifier None Typical Low $3.55 Median $5.01 Typical High $9.55 | Professional | None | $3.55 | $5.01 | $9.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.13 Median $173.78 Typical High $186.21 | Facility | None | $5.13 | $173.78 | $186.21 |
Highmark BCBS Setting Professional Modifier None Typical Low $5.01 Median $5.75 Typical High $7.94 | Professional | None | $5.01 | $5.75 | $7.94 |
Independence Blue Cross Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $5.13 | Professional | None | $4.37 | $4.37 | $5.13 |
Martin's Point Setting Facility Modifier None Typical Low $4.27 Median $5.25 Typical High $1,862.09 | Facility | None | $4.27 | $5.25 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $5.25 | Professional | None | $4.27 | $4.37 | $5.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $2.19 Typical High $2.63 | Professional | 52 · Reduced service | $2.14 | $2.19 | $2.63 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.87 Typical High $1.05 | Professional | 53 · Discontinued | $0.85 | $0.87 | $1.05 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.66 Typical High $0.78 | Professional | 55 · Aftercare only | $0.65 | $0.66 | $0.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.44 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.43 | $0.44 | $0.52 |
Optum Setting Professional Modifier None Typical Low $4.79 Median $6.03 Typical High $6.76 | Professional | None | $4.79 | $6.03 | $6.76 |
Oscar Health Setting Facility Modifier None Typical Low $52.48 Median $72.44 Typical High $79.43 | Facility | None | $52.48 | $72.44 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $3.02 Median $6.03 Typical High $6.76 | Professional | None | $3.02 | $6.03 | $6.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $4.47 Median $50.12 Typical High $79.43 | Facility | None | $4.47 | $50.12 | $79.43 |
UPMC Health Plan Setting Professional Modifier None Typical Low $4.47 Median $5.50 Typical High $6.03 | Professional | None | $4.47 | $5.50 | $6.03 |
United Setting Facility Modifier None Typical Low $51.29 Median $109.65 Typical High $125.89 | Facility | None | $51.29 | $109.65 | $125.89 |
United Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $9.33 | Professional | None | $4.27 | $5.01 | $9.33 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 59 · Distinct service | $4.47 | $4.57 | $4.57 |
Where Pennsylvania sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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
$4.57
ND $8.71NM $3.24
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.