How much rates vary
Facilitymedian $95 · 10th to 90th $60 to $1,862Professionalmedian $105 · 10th to 90th $72 to $214
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 $97.72 Typical High $1,412.54 | Facility | None | $72.44 | $97.72 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $109.65 | Professional | None | $72.44 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $36.31 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $10.72 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.24 | $8.91 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $229.09 | Professional | None | $97.72 | $117.49 | $229.09 |
AmeriHealth Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $194.98 | Professional | None | $109.65 | $141.25 | $194.98 |
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 $123.03 Median $190.55 Typical High $223.87 | Professional | None | $123.03 | $190.55 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $134.90 | Professional | None | $63.10 | $87.10 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $199.53 | Professional | None | $30.90 | $50.12 | $199.53 |
Geisinger Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $169.82 | Professional | None | $72.44 | $85.11 | $169.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $69.18 Median $100.00 Typical High $263.03 | Facility | None | $69.18 | $100.00 | $263.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $177.83 | Professional | None | $114.82 | $147.91 | $177.83 |
Independence Blue Cross Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $194.98 | Professional | None | $128.82 | $151.36 | $194.98 |
Martin's Point Setting Facility Modifier None Typical Low $72.44 Median $97.72 Typical High $194.98 | Facility | None | $72.44 | $97.72 | $194.98 |
Martin's Point Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $104.71 | Professional | None | $72.44 | $95.50 | $104.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $36.31 | $43.65 | $51.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $10.72 | $13.18 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.24 | $8.91 | $10.47 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $223.87 | Professional | None | $85.11 | $123.03 | $223.87 |
UPMC Health Plan Setting Facility Modifier None Typical Low $53.70 Median $81.28 Typical High $112.20 | Facility | None | $53.70 | $81.28 | $112.20 |
UPMC Health Plan Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | None | $95.50 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $138.04 | Professional | None | $74.13 | $97.72 | $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 $87.10 Median $117.49 Typical High $186.21 | Professional | 25 · Same-day visit | $87.10 | $117.49 | $186.21 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $134.90 Typical High $165.96 | Professional | 25 · Same-day visit | $114.82 | $134.90 | $165.96 |
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· 32nd of 51
$105
AK $219DC $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.