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 $3.39 Median $3.39 Typical High $4.17 | Facility | None | $3.39 | $3.39 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $4.17 Typical High $4.17 | Professional | None | $3.39 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.51 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.34 | $0.42 | $0.42 |
AmeriHealth Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
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 $5.50 Median $6.92 Typical High $6.92 | Professional | None | $5.50 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $4.17 Typical High $4.17 | Facility | None | $3.16 | $4.17 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $33.11 | Professional | None | $3.55 | $3.55 | $33.11 |
Emblem Health Setting Professional Modifier None Typical Low $6.46 Median $10.23 Typical High $11.75 | Professional | None | $6.46 | $10.23 | $11.75 |
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 $4.17 Median $4.90 Typical High $7.08 | Professional | None | $4.17 | $4.90 | $7.08 |
Independence Blue Cross Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Martin's Point Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Martin's Point Setting Professional Modifier None Typical Low $3.39 Median $4.17 Typical High $4.17 | Professional | None | $3.39 | $4.17 | $4.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.51 | $0.63 | $0.63 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.34 | $0.42 | $0.42 |
Oscar Health Setting Professional Modifier None Typical Low $6.31 Median $9.77 Typical High $10.47 | Professional | None | $6.31 | $9.77 | $10.47 |
UPMC Health Plan Setting Facility Modifier None Typical Low $4.90 Median $22.39 Typical High $38.02 | Facility | None | $4.90 | $22.39 | $38.02 |
UPMC Health Plan Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $6.61 | Professional | None | $4.90 | $4.90 | $6.61 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.47 Typical High $5.75 | Professional | None | $2.63 | $3.47 | $5.75 |
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 $5.13 Median $5.13 Typical High $6.92 | Professional | KX · Policy requirements met | $5.13 | $5.13 | $6.92 |
Where Pennsylvania sits
The same service costs 2.1 times more in Idaho 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· 28th of 51
$4.17
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.