How much rates vary
Facilitymedian $501 · 10th to 90th $105 to $20,417Professionalmedian $120 · 10th to 90th $87 to $234
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 $91.20 Median $151.36 Typical High $234.42 | Facility | None | $91.20 | $151.36 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $138.04 | Professional | None | $85.11 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $45.71 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $9.55 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $190.55 | Professional | None | $128.82 | $158.49 | $190.55 |
AmeriHealth Setting Facility Modifier None Typical Low $6,456.54 Median $15,135.61 Typical High $22,908.68 | Facility | None | $6,456.54 | $15,135.61 | $22,908.68 |
AmeriHealth Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $199.53 | Professional | None | $114.82 | $114.82 | $199.53 |
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 $120.23 Median $199.53 Typical High $245.47 | Professional | None | $120.23 | $199.53 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,311.31 Typical High $4,786.30 | Facility | None | $1,348.96 | $3,311.31 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $173.78 | Professional | None | $100.00 | $112.20 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $269.15 | Professional | None | $158.49 | $204.17 | $269.15 |
Geisinger Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $245.47 | Professional | None | $109.65 | $144.54 | $245.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $1,698.24 | Facility | None | $331.13 | $331.13 | $1,698.24 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $2,754.23 | Professional | None | $123.03 | $158.49 | $2,754.23 |
Independence Blue Cross Setting Facility Modifier None Typical Low $6,456.54 Median $12,589.25 Typical High $22,908.68 | Facility | None | $6,456.54 | $12,589.25 | $22,908.68 |
Independence Blue Cross Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $204.17 | Professional | None | $114.82 | $114.82 | $204.17 |
Martin's Point Setting Facility Modifier None Typical Low $87.10 Median $162.18 Typical High $1,862.09 | Facility | None | $87.10 | $162.18 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $128.82 | Professional | None | $85.11 | $95.50 | $128.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $45.71 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $45.71 | $47.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $14.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $9.55 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $257.04 | Professional | None | $114.82 | $120.23 | $257.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $213.80 | Facility | None | $104.71 | $128.82 | $213.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $125.89 | Professional | None | $104.71 | $117.49 | $125.89 |
United Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $177.83 | Professional | None | $95.50 | $109.65 | $177.83 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $117.49 Median $169.82 Typical High $194.98 | Professional | 25 · Same-day visit | $117.49 | $169.82 | $194.98 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $123.03 Typical High $234.42 | Professional | 25 · Same-day visit | $114.82 | $123.03 | $234.42 |
Where Pennsylvania sits
The same service costs 2.7 times more in Alaska 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.
Pennsylvania· 31st of 51
$120
AK $263NJ $97.72
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.