How much rates vary
Facilitymedian $102 · 10th to 90th $72 to $4,266Professionalmedian $110 · 10th to 90th $72 to $219
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 $72.44 Median $102.33 Typical High $1,412.54 | Facility | None | $72.44 | $102.33 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $109.65 | Professional | None | $72.44 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $44.67 Typical High $53.70 | Professional | 52 · Reduced service | $36.31 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.49 Typical High $16.22 | Professional | 55 · Aftercare only | $10.72 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.91 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.24 | $8.91 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $234.42 | Professional | None | $89.13 | $117.49 | $234.42 |
AmeriHealth Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $177.83 | Professional | None | $114.82 | $134.90 | $177.83 |
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 $128.82 Median $194.98 Typical High $229.09 | Professional | None | $128.82 | $194.98 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $138.04 | Professional | None | $63.10 | $95.50 | $138.04 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $125.89 Typical High $208.93 | Professional | None | $30.90 | $125.89 | $208.93 |
Geisinger Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $186.21 | Professional | None | $81.28 | $95.50 | $186.21 |
Highmark BCBS Setting Facility Modifier None Typical Low $89.13 Median $123.03 Typical High $138.04 | Facility | None | $89.13 | $123.03 | $138.04 |
Highmark BCBS Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $169.82 | Professional | None | $120.23 | $151.36 | $169.82 |
Independence Blue Cross Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $223.87 | Professional | None | $114.82 | $147.91 | $223.87 |
Martin's Point Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $1,862.09 | Facility | None | $72.44 | $102.33 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $107.15 | Professional | None | $72.44 | $97.72 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $44.67 Typical High $53.70 | Professional | 52 · Reduced service | $36.31 | $44.67 | $53.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.49 Typical High $16.22 | Professional | 55 · Aftercare only | $10.72 | $13.49 | $16.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.91 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.24 | $8.91 | $10.72 |
Optum Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | None | $117.49 | $117.49 | $134.90 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $147.91 | Professional | None | $104.71 | $117.49 | $147.91 |
UPMC Health Plan Setting Facility Modifier None Typical Low $69.18 Median $102.33 Typical High $120.23 | Facility | None | $69.18 | $102.33 | $120.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | None | $102.33 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $138.04 | Professional | None | $74.13 | $102.33 | $138.04 |
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 $100.00 Median $100.00 Typical High $234.42 | Professional | 25 · Same-day visit | $100.00 | $100.00 | $234.42 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $128.82 Median $141.25 Typical High $165.96 | Professional | 25 · Same-day visit | $128.82 | $141.25 | $165.96 |
Where Pennsylvania sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 28th of 51
$110
AK $229DC $81.28
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.