How much rates vary
Facilitymedian $26 · 10th to 90th $18 to $891Professionalmedian $22 · 10th to 90th $18 to $36
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 $17.78 Median $17.78 Typical High $21.88 | Facility | None | $17.78 | $17.78 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $21.88 | Professional | None | $17.78 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $2.63 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.78 | $2.19 | $2.19 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
AmeriHealth Setting Facility Modifier None Typical Low $436.52 Median $691.83 Typical High $1,174.90 | Facility | None | $436.52 | $691.83 | $1,174.90 |
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 $28.84 Median $36.31 Typical High $36.31 | Professional | None | $28.84 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $21.88 | Facility | None | $18.20 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $173.78 | Professional | None | $18.62 | $18.62 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $34.67 Median $54.95 Typical High $63.10 | Professional | None | $34.67 | $54.95 | $63.10 |
Geisinger Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Geisinger Setting Professional Modifier None Typical Low $18.20 Median $21.88 Typical High $37.15 | Professional | None | $18.20 | $21.88 | $37.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $239.88 | Facility | None | $128.82 | $128.82 | $239.88 |
Independence Blue Cross Setting Facility Modifier None Typical Low $436.52 Median $691.83 Typical High $1,174.90 | Facility | None | $436.52 | $691.83 | $1,174.90 |
Martin's Point Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $21.88 | Facility | None | $17.78 | $17.78 | $21.88 |
Martin's Point Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $21.88 | Professional | None | $17.78 | $21.88 | $21.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $2.63 | $3.31 | $3.31 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.78 | $2.19 | $2.19 |
Oscar Health Setting Professional Modifier None Typical Low $24.55 Median $51.29 Typical High $54.95 | Professional | None | $24.55 | $51.29 | $54.95 |
UPMC Health Plan Setting Facility Modifier None Typical Low $25.70 Median $117.49 Typical High $199.53 | Facility | None | $25.70 | $117.49 | $199.53 |
UPMC Health Plan Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
United Setting Professional Modifier None Typical Low $14.13 Median $17.78 Typical High $30.20 | Professional | None | $14.13 | $17.78 | $30.20 |
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 $26.92 Median $26.92 Typical High $36.31 | Professional | KX · Policy requirements met | $26.92 | $26.92 | $36.31 |
Where Pennsylvania sits
The same service costs 2.9 times more in Hawaii than in Rhode Island. 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· 26th of 51
$21.88
HI $47.86RI $16.60
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.