How much rates vary
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 $10.47 Median $10.47 Typical High $13.18 | Facility | None | $10.47 | $10.47 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $13.18 Typical High $13.18 | Professional | None | $10.47 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.58 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.05 | $1.32 | $1.32 |
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 $16.98 Median $21.38 Typical High $21.38 | Professional | None | $16.98 | $21.38 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $12.02 Median $15.14 Typical High $15.14 | Facility | None | $12.02 | $15.14 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $117.49 | Professional | None | $12.88 | $12.88 | $117.49 |
Emblem Health Setting Professional Modifier None Typical Low $19.95 Median $31.62 Typical High $36.31 | Professional | None | $19.95 | $31.62 | $36.31 |
Geisinger Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Geisinger Setting Professional Modifier None Typical Low $10.72 Median $13.18 Typical High $21.88 | Professional | None | $10.72 | $13.18 | $21.88 |
Martin's Point Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Martin's Point Setting Professional Modifier None Typical Low $10.47 Median $13.18 Typical High $13.18 | Professional | None | $10.47 | $13.18 | $13.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.58 | $1.95 | $1.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.05 | $1.32 | $1.32 |
Oscar Health Setting Professional Modifier None Typical Low $14.45 Median $30.90 Typical High $32.36 | Professional | None | $14.45 | $30.90 | $32.36 |
UPMC Health Plan Setting Facility Modifier None Typical Low $15.14 Median $69.18 Typical High $120.23 | Facility | None | $15.14 | $69.18 | $120.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $20.42 | Professional | None | $15.14 | $15.14 | $20.42 |
United Setting Professional Modifier None Typical Low $8.32 Median $10.72 Typical High $17.78 | Professional | None | $8.32 | $10.72 | $17.78 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $13.18 Median $16.22 Typical High $16.22 | Professional | KX · Policy requirements met | $13.18 | $16.22 | $16.22 |
Where Pennsylvania sits
The same service costs 3.5 times more in Hawaii than in Connecticut. 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
$14.45
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.