How much rates vary
Facilitymedian $22 · 10th to 90th $10 to $398Professionalmedian $209 · 10th to 90th $19 to $372
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 $10.00 Median $18.62 Typical High $208.93 | Facility | None | $10.00 | $18.62 | $208.93 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $4.90 Median $5.75 Typical High $10.72 | Facility | 52 · Reduced service | $4.90 | $5.75 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $181.97 Typical High $245.47 | Professional | None | $11.75 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $9.33 Typical High $87.10 | Professional | 52 · Reduced service | $5.75 | $9.33 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $269.15 | Professional | None | $173.78 | $213.80 | $269.15 |
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 $218.78 Median $363.08 Typical High $537.03 | Professional | None | $218.78 | $363.08 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $269.15 | Professional | None | $169.82 | $208.93 | $269.15 |
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 $346.74 | Professional | None | $95.50 | $104.71 | $346.74 |
Geisinger Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $645.65 | Professional | None | $213.80 | $302.00 | $645.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $316.23 | Facility | None | $186.21 | $186.21 | $316.23 |
Martin's Point Setting Facility Modifier None Typical Low $10.00 Median $18.62 Typical High $208.93 | Facility | None | $10.00 | $18.62 | $208.93 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $5.62 Median $6.61 Typical High $10.72 | Facility | 52 · Reduced service | $5.62 | $6.61 | $10.72 |
Martin's Point Setting Professional Modifier None Typical Low $11.75 Median $181.97 Typical High $245.47 | Professional | None | $11.75 | $181.97 | $245.47 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $10.72 Typical High $89.13 | Professional | 52 · Reduced service | $9.33 | $10.72 | $89.13 |
Optum Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $251.19 | Professional | None | $204.17 | $213.80 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $251.19 | Professional | None | $104.71 | $213.80 | $251.19 |
UPMC Health Plan Setting Facility Modifier None Typical Low $208.93 Median $302.00 Typical High $436.52 | Facility | None | $208.93 | $302.00 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $251.19 | Professional | None | $190.55 | $208.93 | $251.19 |
United Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $275.42 | Professional | None | $165.96 | $199.53 | $275.42 |
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 $21.38 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $22.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $26.92 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $22.91 |
Where Pennsylvania sits
The same service costs 2.4 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· 26th of 51
$209
AK $380AL $158
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.