How much rates vary
Facilitymedian $62 · 10th to 90th $26 to $617Professionalmedian $38 · 10th to 90th $21 to $58
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 $26.30 Median $45.71 Typical High $371.54 | Facility | None | $26.30 | $45.71 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $37.15 Typical High $51.29 | Professional | None | $23.99 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.17 Typical High $6.76 | Professional | 55 · Aftercare only | $3.55 | $4.17 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.75 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.34 | $2.75 | $4.57 |
AmeriHealth Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
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 $42.66 Median $44.67 Typical High $97.72 | Professional | None | $42.66 | $44.67 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $22.91 Typical High $54.95 | Professional | None | $13.49 | $22.91 | $54.95 |
Emblem Health Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Geisinger Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $70.79 | Professional | None | $33.88 | $47.86 | $70.79 |
Highmark BCBS Setting Facility Modifier None Typical Low $229.09 Median $416.87 Typical High $707.95 | Facility | None | $229.09 | $416.87 | $707.95 |
Independence Blue Cross Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $7,079.46 | Facility | None | $5,623.41 | $5,623.41 | $7,079.46 |
Martin's Point Setting Facility Modifier None Typical Low $26.30 Median $45.71 Typical High $426.58 | Facility | None | $26.30 | $45.71 | $426.58 |
Martin's Point Setting Professional Modifier None Typical Low $23.99 Median $38.02 Typical High $51.29 | Professional | None | $23.99 | $38.02 | $51.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.17 Typical High $6.76 | Professional | 55 · Aftercare only | $3.63 | $4.17 | $6.76 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.75 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.40 | $2.75 | $4.57 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $74.13 | Professional | None | $38.90 | $38.90 | $74.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $24.55 Median $50.12 Typical High $120.23 | Facility | None | $24.55 | $50.12 | $120.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $24.55 Median $40.74 Typical High $45.71 | Professional | None | $24.55 | $40.74 | $45.71 |
United Setting Facility Modifier None Typical Low $275.42 Median $588.84 Typical High $676.08 | Facility | None | $275.42 | $588.84 | $676.08 |
United Setting Professional Modifier None Typical Low $21.38 Median $34.67 Typical High $46.77 | Professional | None | $21.38 | $34.67 | $46.77 |
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 GC · Resident with teaching physician Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | GC · Resident with teaching physician | $33.88 | $33.88 | $33.88 |
Where Pennsylvania sits
The same service costs 86.3 times more in Connecticut 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.
Physician feeFacility fee
CT $4,814NJ $55.76
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.