How much rates vary
Facilitymedian $132 · 10th to 90th $89 to $1,862Professionalmedian $123 · 10th to 90th $81 to $240
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 $81.28 Median $112.20 Typical High $1,412.54 | Facility | None | $81.28 | $112.20 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $125.89 | Professional | None | $81.28 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $48.98 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $9.77 | $11.75 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $165.96 | Professional | None | $109.65 | $131.83 | $165.96 |
AmeriHealth Setting Facility Modifier None Typical Low $165.96 Median $426.58 Typical High $758.58 | Facility | None | $165.96 | $426.58 | $758.58 |
AmeriHealth Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $151.36 | Professional | None | $125.89 | $147.91 | $151.36 |
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 $141.25 Median $213.80 Typical High $251.19 | Professional | None | $141.25 | $213.80 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $154.88 | Professional | None | $70.79 | $104.71 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $57.54 Typical High $223.87 | Professional | None | $30.90 | $57.54 | $223.87 |
Geisinger Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $204.17 | Professional | None | $87.10 | $102.33 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $89.13 Median $138.04 Typical High $281.84 | Facility | None | $89.13 | $138.04 | $281.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $204.17 | Professional | None | $117.49 | $141.25 | $204.17 |
Independence Blue Cross Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $537.03 | Facility | None | $104.71 | $251.19 | $537.03 |
Independence Blue Cross Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $151.36 | Professional | None | $125.89 | $147.91 | $151.36 |
Martin's Point Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $1,862.09 | Facility | None | $81.28 | $112.20 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $117.49 | Professional | None | $81.28 | $107.15 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $48.98 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $48.98 | $58.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $14.79 | $17.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $9.77 | $11.75 |
Optum Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | None | $128.82 | $128.82 | $147.91 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $162.18 | Professional | None | $104.71 | $128.82 | $162.18 |
UPMC Health Plan Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $177.83 | Facility | None | $107.15 | $125.89 | $177.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $154.88 | Professional | None | $85.11 | $112.20 | $154.88 |
3 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 $97.72 Median $134.90 Typical High $208.93 | Professional | 25 · Same-day visit | $97.72 | $134.90 | $208.93 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | GC · Resident with teaching physician | $144.54 | $144.54 | $144.54 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $117.49 Median $134.90 Typical High $173.78 | Professional | 25 · Same-day visit | $117.49 | $134.90 | $173.78 |
Where Pennsylvania sits
The same service costs 2.7 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
$123
AK $251DC $93.33
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.