How much rates vary
Facilitymedian $18 · 10th to 90th $8 to $398Professionalmedian $151 · 10th to 90th $10 to $204
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 $7.94 Median $14.79 Typical High $173.78 | Facility | None | $7.94 | $14.79 | $173.78 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $3.98 Median $4.79 Typical High $8.71 | Facility | 52 · Reduced service | $3.98 | $4.79 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $144.54 Typical High $204.17 | Professional | None | $9.55 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $7.41 Typical High $69.18 | Professional | 52 · Reduced service | $4.79 | $7.41 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $218.78 | Professional | None | $131.83 | $158.49 | $218.78 |
AmeriHealth Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $302.00 Median $346.74 Typical High $407.38 | Professional | None | $302.00 | $346.74 | $407.38 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $288.40 Typical High $426.58 | Professional | 50 · Both sides | $169.82 | $288.40 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $213.80 | Professional | None | $125.89 | $158.49 | $213.80 |
Emblem Health Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $95.50 | Facility | None | $66.07 | $66.07 | $95.50 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $269.15 | Professional | None | $95.50 | $104.71 | $269.15 |
Geisinger Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $501.19 | Professional | None | $169.82 | $269.15 | $501.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $269.15 | Facility | None | $169.82 | $239.88 | $269.15 |
Independence Blue Cross Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Martin's Point Setting Facility Modifier None Typical Low $7.94 Median $10.96 Typical High $169.82 | Facility | None | $7.94 | $10.96 | $169.82 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $3.98 Median $4.79 Typical High $8.71 | Facility | 52 · Reduced service | $3.98 | $4.79 | $8.71 |
Martin's Point Setting Professional Modifier None Typical Low $9.55 Median $144.54 Typical High $204.17 | Professional | None | $9.55 | $144.54 | $204.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $8.71 Typical High $69.18 | Professional | 52 · Reduced service | $7.41 | $8.71 | $69.18 |
Optum Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $204.17 | Professional | None | $154.88 | $162.18 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $204.17 | Professional | None | $104.71 | $162.18 | $204.17 |
UPMC Health Plan Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $436.52 | Facility | None | $169.82 | $309.03 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $199.53 | Professional | None | $138.04 | $169.82 | $199.53 |
United Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $218.78 | Professional | None | $134.90 | $162.18 | $218.78 |
4 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $16.98 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $18.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $16.98 | $20.89 | $26.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.13 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $14.13 | $18.20 |
Where Pennsylvania sits
The same service costs 2.3 times more in Alaska than in Alabama. 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
$151
AK $288AL $123
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.