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 $21.88 Median $21.88 Typical High $26.92 | Facility | None | $21.88 | $21.88 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $26.92 | Professional | None | $21.88 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.24 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.19 | $2.69 | $2.69 |
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 $35.48 Median $44.67 Typical High $44.67 | Professional | None | $35.48 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $26.92 Typical High $26.92 | Facility | None | $22.39 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $204.17 | Professional | None | $22.91 | $22.91 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $41.69 Median $66.07 Typical High $75.86 | Professional | None | $41.69 | $66.07 | $75.86 |
Geisinger Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Geisinger Setting Professional Modifier None Typical Low $22.39 Median $26.92 Typical High $45.71 | Professional | None | $22.39 | $26.92 | $45.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Martin's Point Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Martin's Point Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $26.92 | Professional | None | $21.88 | $26.92 | $26.92 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.24 | $4.07 | $4.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.19 | $2.69 | $2.69 |
Oscar Health Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $63.10 | Professional | None | $16.60 | $16.60 | $63.10 |
UPMC Health Plan Setting Facility Modifier None Typical Low $31.62 Median $144.54 Typical High $245.47 | Facility | None | $31.62 | $144.54 | $245.47 |
UPMC Health Plan Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $42.66 | Professional | None | $31.62 | $31.62 | $42.66 |
United Setting Professional Modifier None Typical Low $16.98 Median $21.88 Typical High $37.15 | Professional | None | $16.98 | $21.88 | $37.15 |
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 $31.62 Median $33.11 Typical High $33.11 | Professional | KX · Policy requirements met | $31.62 | $33.11 | $33.11 |
Where Pennsylvania sits
The same service costs 2.5 times more in Idaho than in Kentucky. 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· 27th of 51
$26.92
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.