How much rates vary
Facilitymedian $14 · 10th to 90th $10 to $155Professionalmedian $12 · 10th to 90th $9 to $19
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 $9.33 Median $9.33 Typical High $16.22 | Facility | None | $9.33 | $9.33 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $11.75 Typical High $11.75 | Professional | None | $9.33 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.41 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.93 | $1.17 | $1.17 |
AmeriHealth Setting Facility Modifier None Typical Low $70.79 Median $112.20 Typical High $190.55 | Facility | None | $70.79 | $112.20 | $190.55 |
AmeriHealth Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
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 $15.14 Median $19.05 Typical High $19.05 | Professional | None | $15.14 | $19.05 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $13.49 | Facility | None | $9.55 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $107.15 | Professional | None | $11.48 | $11.48 | $107.15 |
Emblem Health Setting Professional Modifier None Typical Low $20.89 Median $33.11 Typical High $38.02 | Professional | None | $20.89 | $33.11 | $38.02 |
Geisinger Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Geisinger Setting Professional Modifier None Typical Low $9.55 Median $11.75 Typical High $19.50 | Professional | None | $9.55 | $11.75 | $19.50 |
Highmark BCBS Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Independence Blue Cross Setting Facility Modifier None Typical Low $70.79 Median $112.20 Typical High $190.55 | Facility | None | $70.79 | $112.20 | $190.55 |
Independence Blue Cross Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Martin's Point Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $16.22 | Facility | None | $9.33 | $9.33 | $16.22 |
Martin's Point Setting Professional Modifier None Typical Low $9.33 Median $11.75 Typical High $11.75 | Professional | None | $9.33 | $11.75 | $11.75 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.41 | $1.74 | $1.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.93 | $1.17 | $1.17 |
Oscar Health Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $26.92 | Professional | None | $12.88 | $12.88 | $26.92 |
UPMC Health Plan Setting Facility Modifier None Typical Low $14.45 Median $61.66 Typical High $107.15 | Facility | None | $14.45 | $61.66 | $107.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $18.20 | Professional | None | $14.45 | $14.45 | $18.20 |
United Setting Professional Modifier None Typical Low $7.41 Median $9.55 Typical High $15.85 | Professional | None | $7.41 | $9.55 | $15.85 |
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 $11.75 Median $14.13 Typical High $14.13 | Professional | KX · Policy requirements met | $11.75 | $14.13 | $14.13 |
Where Pennsylvania sits
The same service costs 2.8 times more in Hawaii 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· 33rd of 51
$12.30
HI $27.54CT $10.00
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.