How much rates vary
Facilitymedian $2 · 10th to 90th $2 to $19Professionalmedian $2 · 10th to 90th $2 to $3
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 $1.51 Median $1.51 Typical High $2.75 | Facility | None | $1.51 | $1.51 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.91 Typical High $1.91 | Professional | None | $1.51 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.23 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.15 | $0.19 | $0.19 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
AmeriHealth Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
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 $2.45 Median $3.09 Typical High $3.09 | Professional | None | $2.45 | $3.09 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.29 | Facility | None | $1.86 | $1.86 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $15.49 | Professional | None | $1.58 | $1.58 | $15.49 |
Emblem Health Setting Professional Modifier None Typical Low $2.88 Median $4.57 Typical High $5.37 | Professional | None | $2.88 | $4.57 | $5.37 |
Geisinger Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Geisinger Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $3.16 | Professional | None | $1.91 | $2.19 | $3.16 |
Highmark BCBS Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Independence Blue Cross Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Martin's Point Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $2.75 | Facility | None | $1.51 | $1.51 | $2.75 |
Martin's Point Setting Professional Modifier None Typical Low $1.51 Median $1.91 Typical High $1.91 | Professional | None | $1.51 | $1.91 | $1.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.23 | $0.28 | $0.28 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.15 | $0.19 | $0.19 |
Oscar Health Setting Professional Modifier None Typical Low $2.82 Median $4.37 Typical High $4.68 | Professional | None | $2.82 | $4.37 | $4.68 |
UPMC Health Plan Setting Facility Modifier None Typical Low $2.19 Median $10.00 Typical High $16.98 | Facility | None | $2.19 | $10.00 | $16.98 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.95 | Professional | None | $2.19 | $2.19 | $2.95 |
United Setting Professional Modifier None Typical Low $1.17 Median $1.55 Typical High $2.57 | Professional | None | $1.17 | $1.55 | $2.57 |
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 $2.34 Median $2.34 Typical High $2.34 | Professional | KX · Policy requirements met | $2.34 | $2.34 | $2.34 |
Where Pennsylvania sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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· 25th of 51
$1.95
HI $4.57NH $1.55
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.