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 $3.47 Median $3.47 Typical High $4.27 | Facility | None | $3.47 | $3.47 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $4.27 Typical High $4.27 | Professional | None | $3.47 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.52 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.34 | $0.43 | $0.43 |
Ambetter Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
AmeriHealth Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
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 $6.31 Median $7.08 Typical High $7.08 | Professional | None | $6.31 | $7.08 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Emblem Health Setting Professional Modifier None Typical Low $9.33 Median $10.00 Typical High $12.88 | Professional | None | $9.33 | $10.00 | $12.88 |
Geisinger Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Geisinger Setting Professional Modifier None Typical Low $3.55 Median $3.72 Typical High $7.08 | Professional | None | $3.55 | $3.72 | $7.08 |
Martin's Point Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
Martin's Point Setting Professional Modifier None Typical Low $3.47 Median $4.27 Typical High $4.27 | Professional | None | $3.47 | $4.27 | $4.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.52 | $0.65 | $0.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.34 | $0.43 | $0.43 |
Oscar Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $10.00 | Professional | None | $4.79 | $4.79 | $10.00 |
UPMC Health Plan Setting Facility Modifier None Typical Low $5.01 Median $22.91 Typical High $38.90 | Facility | None | $5.01 | $22.91 | $38.90 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $6.76 | Professional | None | $5.01 | $5.01 | $6.76 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $5.01 | Professional | None | $3.16 | $3.47 | $5.01 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | KX · Policy requirements met | $5.37 | $5.37 | $5.37 |
Where Pennsylvania sits
The same service costs 2.5 times more in Idaho than in Colorado. 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
$4.27
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.